Active NPI
Anne Kathleen Roseberry, LCSW
- Clinical Social Worker
- Buffalo, NY
National Provider Identifier
1477693034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R026994-1
- Practice address
- 3 Gates Cir
Child & Adolescent Psychiatry - 8TH Floor
Buffalo, NY 14209-1120 - Phone
- (716) 887-5788
- Fax
- (716) 887-5801
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | R026994-1 | NY | Primary |
Addresses
Primary practice location
3 Gates Cir
Child & Adolescent Psychiatry - 8TH Floor
Buffalo, NY 14209-1120
Mailing address
3 Gates Cir
Child & Adolescent Psychiatry - 8TH Floor
Buffalo, NY 14209-1120
Phone (716) 887-5788
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6190467 | Other | NY | INDEPEN. HEALTH PROV # |
| 000590297001 | Other | NY | BLUE CROSS PROV # |
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 |
|---|---|---|---|
| R026994-1 | NY | MD | Clinical Social Worker |
| 026994 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477693034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 GATES CIR",
"address_2": "CHILD & ADOLESCENT PSYCHIATRY - 8TH FLOOR",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142091120",
"telephone_number": "716-887-5788",
"fax_number": "716-887-5801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 GATES CIR",
"address_2": "CHILD & ADOLESCENT PSYCHIATRY - 8TH FLOOR",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142091120",
"telephone_number": "716-887-5788",
"fax_number": "716-887-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEBERRY",
"first_name": "ANNE",
"middle_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R026994-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPEN. HEALTH PROV #",
"identifier": "6190467",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROV #",
"identifier": "000590297001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, 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.