Bailey Renstrom, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096555-1 Issued in NY

Practice address

201 Cardinal Dr
Montgomery, NY 12549-1710

Phone

(845) 204-4542

NPI assigned

May 13, 2016

Last updated

May 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1407202906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CARDINAL DR",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125491710",
            "telephone_number": "845-204-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CARDINAL DR",
            "city": "MONTGOMERY",
            "state": "NY",
            "postal_code": "125491710",
            "telephone_number": "845-204-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENSTROM",
        "first_name": "BAILEY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096555-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Montgomery, NY
• Providers in Montgomery, 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 May 13, 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.