Individual provider Active NPI

Serina Marshe-Ragland Tetenov, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1417288796
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73076792 Issued in NY
Practice address
224 Alexander St
Rochester, NY 14607-4000
Phone
(585) 922-7741
Fax
(585) 922-7246
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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 73076792 NY Primary

Addresses

Primary practice location

224 Alexander St
Rochester, NY 14607-4000

Mailing address

224 Alexander St
Rochester, NY 14607-4000
Phone (585) 922-7741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73076792NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Jul 1, 2022 Accepting new patients
University of Rochester CurrentSince Jul 1, 2022 Accepting new patients
University of Rochester Current Accepting new patients
Villa of Hope CurrentSince May 3, 2024 Accepting new patients

Locations

247 N Goodman St
Rochester, NY 14607
Phone (585) 627-5892

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#684
Rochester, NY 14642
Phone (585) 784-9503

3300 Dewey Ave
Rochester, NY 14616
Phone (585) 865-1550

Organizations & group practices 4

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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1417288796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 ALEXANDER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074000",
            "telephone_number": "585-922-7741",
            "fax_number": "585-922-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ALEXANDER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146074000",
            "telephone_number": "585-922-7741",
            "fax_number": "585-922-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETENOV",
        "first_name": "SERINA",
        "middle_name": "MARSHE-RAGLAND",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73076792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.