Active NPI
Joan E Riesenberger, LCSW-R
- Clinical Social Worker
- Penfield, NY
National Provider Identifier
1386883189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R070540-1
- Practice address
- 401 Penbrooke Dr
Building 2, Suite K
Penfield, NY 14526-2041 - Phone
- (585) 377-6470
- NPI assigned
- Feb 18, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R070540-1 | NY | Primary |
| Marriage & Family Therapist | 106H00000X | 000502-1 | NY |
Addresses
Primary practice location
401 Penbrooke Dr
Building 2, Suite K
Penfield, NY 14526-2041
Mailing address
401 Penbrooke Dr
Building 2, Suite K
Penfield, NY 14526-2041
Phone (585) 377-6470
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
| License | State | Type | Specialty |
|---|---|---|---|
| R070540-1 | NY | MD | Clinical Social Worker |
| 000502-1 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234915200000",
"number": "1386883189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 PENBROOKE DR",
"address_2": "BUILDING 2, SUITE K",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145262041",
"telephone_number": "585-377-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PENBROOKE DR",
"address_2": "BUILDING 2, SUITE K",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145262041",
"telephone_number": "585-377-6470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIESENBERGER",
"first_name": "JOAN",
"middle_name": "E",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-18",
"last_updated": "2009-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R070540-1",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "000502-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penfield, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.