Sharon Marie Dougherty, RN, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R040221 Issued in NY

Practice address

1250 William Floyd Parkway
Shirley, NY 11967

Phone

(631) 913-3526

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Dynamic Counseling LCSW PCGroup PAC ID 2163839135, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dynamic Counseling LCSW PC

  • Mental Health Counselor
  • Commack, NY
  • NPI 1457949562
  Medicare reassignment Care Compare group NPD
• Roberta a Bianco Dopc

  • Primary Care Clinic/Center
  • Smithtown, NY
  • NPI 1609032887
  Medicare reassignment NPD
• Satpal Rathour Medicine PC

  • Specialist
  • Shirley, NY
  • NPI 1881987584
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1346676707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE",
            "address_2": "STE 202",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873234",
            "telephone_number": "631-913-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 WILLIAM FLOYD PARKWAY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "11967",
            "telephone_number": "631-913-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN, LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "3709361",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Detomaso
• Anita Digiacomo
• Sefika Dimaggio, RN
• Tracy Diorio, LCSW-R
• Nanette Charlene Dorsey
• Dr. Walter Alexovitz D.C.P.C.
• Amanda Drenzyk, BCBA
• Kimberly Duffy, MD
• Dummuzi Christopher Duhaney, LMSW
• Tara Dunn

• Clinical Social Worker in Shirley, NY
• Providers in Shirley, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.

Verify at the official NPI Registry.