Individual provider Active NPI

Virginia Bertsch Quackenbush, LMSW

  • School Social Worker
  • Apalachin, NY
National Provider Identifier
1487956975
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
062512-1 Issued in NY
Practice address
471 Pennsylvania Ave
TLC/Boces
Apalachin, NY 13732-2501
Phone
(607) 748-8261
Fax
(607) 748-8262
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 062512-1 NY Primary

Addresses

Primary practice location

471 Pennsylvania Ave
TLC/Boces
Apalachin, NY 13732-2501

Mailing address

471 Pennsylvania Ave
TLC/Boces
Apalachin, NY 13732-2501
Phone (607) 748-8261

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
062512-1NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1487956975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 PENNSYLVANIA AVE",
            "address_2": "TLC/BOCES",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137322501",
            "telephone_number": "607-748-8261",
            "fax_number": "607-748-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 PENNSYLVANIA AVE",
            "address_2": "TLC/BOCES",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137322501",
            "telephone_number": "607-748-8261",
            "fax_number": "607-748-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACKENBUSH",
        "first_name": "VIRGINIA",
        "middle_name": "BERTSCH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "062512-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apalachin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.