Individual provider Active NPI

Claudette P McGowan-Wells, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1366560294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO31139-1 Issued in NY
Practice address
2105 W Genesee St
Syracuse, NY 13219-1656
Phone
(315) 488-1884
Fax
(315) 488-1884
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RO31139-1 NY Primary

Addresses

Primary practice location

2105 W Genesee St
Syracuse, NY 13219-1656

Mailing address

2105 W Genesee St
Syracuse, NY 13219-1656
Phone (315) 488-1884

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO31139-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366560294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191656",
            "telephone_number": "315-488-1884",
            "fax_number": "315-488-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191656",
            "telephone_number": "315-488-1884",
            "fax_number": "315-488-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN-WELLS",
        "first_name": "CLAUDETTE",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO31139-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.