Active NPI
Stephen H Davie, LCSW-R
- Clinical Social Worker
- Hudson Falls, NY
National Provider Identifier
1457414831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR012566-1
- Practice address
- 15 Boulevard St
Hudson Falls, NY 12839-1001 - Phone
- (518) 747-2994
- Fax
- (518) 747-2996
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR012566-1 | NY | Primary |
Addresses
Primary practice location
15 Boulevard St
Hudson Falls, NY 12839-1001
Mailing address
15 Boulevard St
Hudson Falls, NY 12839-1001
Phone (518) 747-2994
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TRI-CARE | Other | NY | 12034176 |
| MVP | Other | NY | 377615 |
| VALUE OPTIONS | Other | NY | 476662 |
| VALUE OPTIONS | Other | NY | 7340690002 |
| BCBS OF NE NY | Other | NY | 000403428001 |
| FIDELIS | Other | NY | 050721000016 |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR012566-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457414831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BOULEVARD ST",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128391001",
"telephone_number": "518-747-2994",
"fax_number": "518-747-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BOULEVARD ST",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128391001",
"telephone_number": "518-747-2994",
"fax_number": "518-747-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIE",
"first_name": "STEPHEN",
"middle_name": "H",
"credential": "LCSW-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR012566-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "12034176",
"identifier": "TRI-CARE",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "377615",
"identifier": "MVP",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "476662",
"identifier": "VALUE OPTIONS",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "7340690002",
"identifier": "VALUE OPTIONS",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "000403428001",
"identifier": "BCBS OF NE NY",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "050721000016",
"identifier": "FIDELIS",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.