John Joseph Haverlick, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR009313-1 Issued in NY

Practice address

10897 Nys Route 9N,
Suite4
Keene, NY 12942-9998

Phone

(518) 576-4557

NPI assigned

Jun 27, 2006

Last updated

Jul 31, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1966

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: johnhaverlick@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Counseling Center of Keene New York Inc

  dba Samaritan Family Counseling Center

  • Mental Health Counselor
  • Keene, NY
  • NPI 1710923115
  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Adirondack Medical Center

  • General Practice Physician
  • Saranac Lake, NY
  • NPI 1245446533

  Clinical

  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1396772216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BEEDE LN",
            "city": "KEENE VALLEY",
            "state": "NY",
            "postal_code": "129432004",
            "telephone_number": "518-963-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10897 NYS ROUTE 9N,",
            "address_2": "SUITE4",
            "city": "KEENE",
            "state": "NY",
            "postal_code": "129429998",
            "telephone_number": "518-576-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLICK",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "PR009313-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR009313-1",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "PR009313-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Baillargeon, RD
• Susan Bass, LCSW
• Marie Kay Cogar, LMFT
• Lynn Ruth Edmonds, RN, MS
• Family Counseling Center of Keene New York Inc (Samaritan Family Counseling Center)
• Keene Emergency Medical Services Inc
• Devon McCabe, FNP-BC
• Javier Eduardo Perez, LMSW
• David Earl Smith, REV

• Clinical Social Worker in Keene, NY
• Providers in Keene, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.