Individual provider Active NPI

Stefanie Ann Gross

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1396930624
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079681 Issued in NY
Practice address
35 Dock St
Andrus Children's Center
Yonkers, NY 10701-2733
Phone
(914) 965-1109
Fax
(914) 965-9705
NPI assigned
Sep 10, 2007
Last updated
Oct 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Clinical Social Worker 1041C0700X 082622 NY
Clinical Social Worker 1041C0700X 079681 NY Primary

Addresses

Primary practice location

35 Dock St
Andrus Children's Center
Yonkers, NY 10701-2733

Mailing address

1156 N Broadway
Andrus Children's Center
Yonkers, NY 10701-1108
Phone (914) 965-3700

Other identifiers 3

IdentifierTypeStateIssuer
1285628552OtherNYAGENCY NPI
WVE061OtherNYAGENCY MEDICARE #
00355940OtherNYAGENCY MEDICAID #

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1396930624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 N BROADWAY",
            "address_2": "ANDRUS CHILDREN'S CENTER",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108",
            "telephone_number": "914-965-3700",
            "fax_number": "914-965-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 DOCK ST",
            "address_2": "ANDRUS CHILDREN'S CENTER",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012733",
            "telephone_number": "914-965-1109",
            "fax_number": "914-965-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "STEFANIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082622",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY NPI",
            "identifier": "1285628552",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICARE #",
            "identifier": "WVE061",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICAID #",
            "identifier": "00355940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.