Active NPI
Michael Eversman, LCSWR
- Clinical Social Worker
- Albany, NY
National Provider Identifier
1497770804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R061749-1
- Practice address
- 1 Pinnacle Place Ste 102
Albany, NY 12203 - Phone
- (518) 689-0244
- Fax
- (518) 689-0241
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 | R061749-1 | NY | Primary |
Addresses
Primary practice location
1 Pinnacle Place Ste 102
Albany, NY 12203
Mailing address
1 Pinnacle Place Ste 102
Albany, NY 12203
Phone (518) 689-0244
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 |
|---|---|---|---|
| R061749-1 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph Ippolito | Clinical | Past | Accepting new patients |
| Pinnacle Behavioral Health | Clinical | Past | Accepting new patients |
| Pinnacle Behavioral Health Ipa PLLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Mental Health Counselor
- Albany, NY
- NPI 1447276720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497770804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PINNACLE PLACE STE 102",
"city": "ALBANY",
"state": "NY",
"postal_code": "12203",
"telephone_number": "518-689-0244",
"fax_number": "518-689-0241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PINNACLE PLACE STE 102",
"city": "ALBANY",
"state": "NY",
"postal_code": "12203",
"telephone_number": "518-689-0244",
"fax_number": "518-689-0241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERSMAN",
"first_name": "MICHAEL",
"credential": "LCSWR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R061749-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, 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.