Individual provider Active NPI

Dean Mark Squires Jr., LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1366386781
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
113398 Issued in NY
Practice address
620 Erie Blvd W Ste 302
Syracuse, NY 13204-2463
Phone
(315) 551-2909
Fax
(315) 551-2909
NPI assigned
Apr 16, 2026
Last updated
Apr 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113398 NY Primary

Addresses

Primary practice location

620 Erie Blvd W Ste 302
Syracuse, NY 13204-2463

Mailing address

620 Erie Blvd W Ste 302
Syracuse, NY 13204-2463
Phone (315) 551-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113398NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1366386781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042463",
            "telephone_number": "315-551-2909",
            "fax_number": "315-551-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042463",
            "telephone_number": "315-551-2909",
            "fax_number": "315-551-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "DEAN",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.