Active NPI
Edyle Obrien, LCSW
- Social Worker
- East Hampton, NY
National Provider Identifier
1356534002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 047821 1
- Practice address
- 16 Diane Drive
East Hampton, NY 11937 - Phone
- (631) 786-3650
- NPI assigned
- Aug 24, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 047821 1 | NY | Primary |
Addresses
Primary practice location
16 Diane Drive
East Hampton, NY 11937
Mailing address
16 Diane Drive
East Hampton, NY 11937
Phone (631) 786-3650
Other names 1
- Ms. Edyle Copillo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2018 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047821 1 | NY | MD | Social Worker |
| 047821 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1356534002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 DIANE DRIVE",
"city": "EAST HAMPTON",
"state": "NY",
"postal_code": "11937",
"telephone_number": "631-786-3650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 DIANE DRIVE",
"city": "EAST HAMPTON",
"state": "NY",
"postal_code": "11937",
"telephone_number": "631-786-3650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "EDYLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-24",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "047821 1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EDYLE",
"last_name": "COPILLO",
"prefix": "MS.",
"credential": "CSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in East Hampton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.