Individual provider Active NPI

Sarah M Reynolds, LCSW

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1336697283
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089700 Issued in NY
Practice address
425 Robinson St
Binghamton, NY 13904-1735
Phone
(607) 773-4520
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 087507 NY
Clinical Social Worker 1041C0700X 089700 NY Primary

Addresses

Primary practice location

425 Robinson St
Binghamton, NY 13904-1735

Mailing address

269 Riverside Dr
Johnson City, NY 13790-2726
Phone (607) 205-8601

Other practice location 1

269 Riverside Dr
Johnson City, NY 13790-2726
Phone (607) 205-8601

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201005000835 NY Practitioner - Clinical Social Worker 6507285970 Practice locations: Johnson City, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087507NYMDClinical Social Worker
089700NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1336697283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 RIVERSIDE DR",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902726",
            "telephone_number": "607-205-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 ROBINSON ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041735",
            "telephone_number": "607-773-4520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "137902726",
            "country_code": "US",
            "telephone_number": "607-205-8601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SARAH",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087507",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.