Active NPI
Debra Perkes, LCSW
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1336207489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R017076
- Practice address
- 1 Edgewood Ave
Smithtown, NY 11787-2742 - Phone
- (631) 543-4140
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R017076 | NY | Primary |
Addresses
Primary practice location
1 Edgewood Ave
Smithtown, NY 11787-2742
Mailing address
33 Grassy Pond Dr
Smithtown, NY 11787-4027
Phone (631) 543-4140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040424000368 | NY | Practitioner - Clinical Social Worker | 0042206930 | Practice locations: Bronx, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5700 Arlington Ave
Apt 19B
Bronx, NY 10471-1521
Phone (516) 313-7503
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017076 | NY | MD | Psychologist |
| R017076 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336207489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 GRASSY POND DR",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874027",
"telephone_number": "631-543-4140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EDGEWOOD AVE",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872742",
"telephone_number": "631-543-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKES",
"first_name": "DEBRA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R017076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.