Individual provider Active NPI

Sally A Smith

  • Clinical Social Worker
  • Cold Spring, NY
National Provider Identifier
1497639561
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW19437 Issued in CA
Practice address
16 Constitution Dr
Cold Spring, NY 10516-3106
Phone
(415) 420-4358
NPI assigned
Aug 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW19437 CA Primary

Addresses

Primary practice location

16 Constitution Dr
Cold Spring, NY 10516-3106

Mailing address

16 Constitution Dr
Cold Spring, NY 10516-3106
Phone (415) 420-4358

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
LCSW19437CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1497639561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CONSTITUTION DR",
            "city": "COLD SPRING",
            "state": "NY",
            "postal_code": "105163106",
            "telephone_number": "415-420-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CONSTITUTION DR",
            "city": "COLD SPRING",
            "state": "NY",
            "postal_code": "105163106",
            "telephone_number": "415-420-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SALLY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW19437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cold Spring, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; 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.