Individual provider Active NPI

Donna L George, LCSW

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1447871629
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087520-1 Issued in NY
Practice address
106 Troy Rd
Ithaca, NY 14850-9447
Phone
(607) 272-0315
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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 087520-1 NY Primary

Addresses

Primary practice location

106 Troy Rd
Ithaca, NY 14850-9447

Mailing address

106 Troy Rd
Ithaca, NY 14850-9447
Phone (607) 272-0315

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
I20210222001316 NY Practitioner - Clinical Social Worker 7416362611 Practice locations: Ithaca, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

106 Troy Rd
Ithaca, NY 14850-9447
Phone (607) 229-5798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087520-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1447871629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 TROY RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509447",
            "telephone_number": "607-272-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 TROY RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509447",
            "telephone_number": "607-272-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "DONNA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087520-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.