Individual provider Active NPI

Cassandra Kirk

  • Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1417725359
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
121105-01 Issued in NY
Practice address
10 Childrens Way
Poughkeepsie, NY 12601-1499
Phone
(845) 396-3268
NPI assigned
Dec 19, 2023
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 121105-01 NY Primary

Addresses

Primary practice location

10 Childrens Way
Poughkeepsie, NY 12601-1499

Mailing address

1 River PL Apt 525
New York, NY 10036-4363
Phone (845) 443-1278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
121105-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1417725359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVER PL APT 525",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364363",
            "telephone_number": "845-443-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CHILDRENS WAY",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011499",
            "telephone_number": "845-396-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "121105-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.