Individual provider Active NPI

Tina Lynn Vannoy, LCSW

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1417077728
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074200-1 Issued in NY
Practice address
1 Hawley St
2ND Floor
Binghamton, NY 13901-3141
Phone
(607) 778-1121
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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 074200-1 NY Primary

Addresses

Primary practice location

1 Hawley St
2ND Floor
Binghamton, NY 13901-3141

Mailing address

844 E Windsor Rd
Windsor, NY 13865-1819
Phone (607) 725-0661

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
I20050512000394 NY Practitioner - Clinical Social Worker 2264473958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074200-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Nov 13, 2019 Accepting new patients
Broome County Past Accepting new patients
Broome County Mental Health Department PastSince Jan 1, 2001 Accepting new patients

Locations

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1417077728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 E WINDSOR RD",
            "city": "WINDSOR",
            "state": "NY",
            "postal_code": "138651819",
            "telephone_number": "607-725-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAWLEY ST",
            "address_2": "2ND FLOOR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139013141",
            "telephone_number": "607-778-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNOY",
        "first_name": "TINA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074200-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.