Cori Lynn Kapopoulos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092754-01 Issued in NY

Practice address

28 Winding Path
Manorville, NY 11949

Phone

(631) 603-4988

NPI assigned

Feb 18, 2022

Last updated

Feb 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Janice Martin Licensed Clinical Social Worker PCGroup PAC ID 6305252537, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Janice Martin Licensed Clinical Social Worker PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Jefferson, NY
  • NPI 1902427941
  Medicare reassignment Care Compare group
• Shine Medical PC

  • Psychiatry Physician
  • New York, NY
  • NPI 1427783950

  Multi-Specialty

  NPD (past)
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1477208361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "EASTPORT",
            "state": "NY",
            "postal_code": "119410248",
            "telephone_number": "631-603-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WINDING PATH",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "11949",
            "telephone_number": "631-603-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOPOULOS",
        "first_name": "CORI",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "22189",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092754-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jakob
• Jefferson Sports & Physical Therapy, PC
• Maryanne Jimenez
• Maria Josephs, PT
• Samantha Justesen
• Denise M Karavas, PA
• Lester S. Keller, DPM
• Kerri Petitpain Medical
• John M Kiesecker, D.C.
• Judi-Ann Killean, RN

• Clinical Social Worker in Manorville, NY
• Providers in Manorville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.