Individual provider Active NPI

Stephanie Lil Dorman, LMSW

  • Social Worker
  • Lackawanna, NY
National Provider Identifier
1386801702
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
060469-1 Issued in NY
Practice address
650 Ridge Rd
BVS
Lackawanna, NY 04828-9700
Phone
(716) 828-9670
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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 060469-1 NY Primary

Addresses

Primary practice location

650 Ridge Rd
BVS
Lackawanna, NY 04828-9700

Mailing address

650 Ridge Rd
BVS
Lackawanna, NY 04828-9700
Phone (716) 828-9670

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
060469-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1386801702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 RIDGE RD",
            "address_2": "BVS",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "048289700",
            "telephone_number": "716-828-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RIDGE RD",
            "address_2": "BVS",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "048289700",
            "telephone_number": "716-828-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "STEPHANIE",
        "middle_name": "LIL",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "060469-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.