Individual provider Active NPI

Andrea L Papp, LCSW-R

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1477996817
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083034-1 Issued in NY
Practice address
22 Lawrence Ave Ste 213
Smithtown, NY 11787-3619
Phone
(631) 721-4030
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 085604-1 NY
Clinical Social Worker 1041C0700X 083034-1 NY Primary

Addresses

Primary practice location

22 Lawrence Ave Ste 213
Smithtown, NY 11787-3619

Mailing address

75 Longfellow Dr
Kings Park, NY 11754-2344
Phone (516) 313-2899

Other identifiers 1

IdentifierTypeStateIssuer
03602893MedicaidNY

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
I20151020001959 NY Practitioner - Clinical Social Worker 5890004584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castle Counseling LCSW PCGroup PAC ID 5092024992, 2 clinicians

Practice addresses (Care Compare)

75 Longfellow Dr
Kings Park, NY 11754-2344
Phone (516) 313-2899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085604-1NYMDSocial Worker
083034-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Counseling LCSW PC Clinical CurrentSince Aug 21, 2015 Accepting new patients

Locations

22 Lawrence Ave
Ste 213
Smithtown, NY 11787
Phone (631) 265-0877

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1477996817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LONGFELLOW DR",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542344",
            "telephone_number": "516-313-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LAWRENCE AVE STE 213",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873619",
            "telephone_number": "631-721-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPP",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "085604-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083034-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03602893",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.