Individual provider Active NPI

Laura Lee Tice, LCSWR

  • Social Worker
  • Delmar, NY
National Provider Identifier
1407086234
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R0544411 Issued in NY
Practice address
107 Adams PL
Delmar, NY 12054-3023
Phone
(518) 573-8743
Fax
(518) 514-1299
NPI assigned
Jul 14, 2009
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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 R0544411 NY Primary

Addresses

Primary practice location

107 Adams PL
Delmar, NY 12054-3023

Mailing address

107 Adams PL
Delmar, NY 12054-3023
Phone (518) 573-8743

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091008000394 NY Practitioner - Clinical Social Worker 0244376044 Practice locations: Troy, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

270 River St
Suite 202B
Troy, NY 12180-0806
Phone (518) 573-8743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0544411NYMDSocial Worker
054441NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Access Initiative Incorporated CurrentSince Aug 11, 2019 Accepting new patients
Laura Tice, LCSW R PastSince Sep 17, 2020 Accepting new patients

Locations

10 Colvin Ave
Ste 102
Albany, NY 12206
Phone (518) 438-2222

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1407086234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ADAMS PL",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120543023",
            "telephone_number": "518-573-8743",
            "fax_number": "518-514-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ADAMS PL",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120543023",
            "telephone_number": "518-573-8743",
            "fax_number": "518-514-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0544411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delmar, NY

Sources for this page

Verify at the official NPI Registry.