Individual provider Active NPI

Mary Elizabeth York, LCSW-R

  • Clinical Social Worker
  • Glens Falls, NY
National Provider Identifier
1346303369
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R044854-1 Issued in NY
Practice address
92 Bay St
Glens Falls, NY 12801-3031
Phone
(518) 636-3778
Fax
(518) 244-8960
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R044854-1 NY Primary

Addresses

Primary practice location

92 Bay St
Glens Falls, NY 12801-3031

Mailing address

92 Bay St
Glens Falls, NY 12801-3031
Phone (518) 636-3778

Other practice location 1

15 Boulevard St
Hudson Falls, NY 12839-1001
Phone (518) 747-2994

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
I20070912000267 NY Practitioner - Clinical Social Worker 8729171343 Practice locations: Glens Falls, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

92 Bay St
Glens Falls, NY 12801-3031
Phone (518) 636-3778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R044854-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346303369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 BAY ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013031",
            "telephone_number": "518-636-3778",
            "fax_number": "518-244-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BAY ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013031",
            "telephone_number": "518-636-3778",
            "fax_number": "518-244-8960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Boulevard St",
            "address_purpose": "LOCATION",
            "city": "Hudson Falls",
            "state": "NY",
            "postal_code": "128391001",
            "country_code": "US",
            "telephone_number": "518-747-2994",
            "fax_number": "518-747-2996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YORK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R044854-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.