Individual provider Active NPI

Joyce Ann Racanelli, LCSW

  • Clinical Social Worker
  • East Islip, NY
National Provider Identifier
1407249212
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079192-1 Issued in NY
Practice address
216 Carleton Ave
East Islip, NY 11730-1222
Phone
(631) 902-6786
NPI assigned
Mar 18, 2015
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 079192-1 NY Primary

Addresses

Primary practice location

216 Carleton Ave
East Islip, NY 11730-1222

Mailing address

311 Woodland Dr
Brightwaters, NY 11718-1924
Phone (631) 902-6786

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
I20150915001321 NY Practitioner - Clinical Social Worker 9739496340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Visiting Counselors LCSW PLLCGroup PAC ID 8426393968, 28 clinicians

Practice addresses (Care Compare)

900 Walt Whitman Rd
Suite LL1
Melville, NY 11747-2215
Phone (516) 698-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079192-1NYMDClinical Social Worker

Organizations & group practices 1

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": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1407249212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 WOODLAND DR",
            "city": "BRIGHTWATERS",
            "state": "NY",
            "postal_code": "117181924",
            "telephone_number": "631-902-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 CARLETON AVE",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301222",
            "telephone_number": "631-902-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACANELLI",
        "first_name": "JOYCE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079192-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

Verify at the official NPI Registry.