Individual provider Active NPI

Zeanna Deyo, LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1417609488
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112413 Issued in NY
Practice address
1045 James St
Syracuse, NY 13203-2730
Phone
(315) 472-4471
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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 112413 NY Primary

Addresses

Primary practice location

1045 James St
Syracuse, NY 13203-2730

Mailing address

4 1/2 Mechanic St
Camillus, NY 13031-1013
Phone (315) 882-5706

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
I20250917002772 NY Practitioner - Clinical Social Worker 0143724765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

1045 James St
Syracuse, NY 13203-2730
Phone 31547244711384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112413NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Liberty Resources Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1417609488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 1/2 MECHANIC ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311013",
            "telephone_number": "315-882-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYO",
        "first_name": "ZEANNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.