Individual provider Active NPI

Tamie Coleman, LCSW

  • Clinical Social Worker
  • Jamestown, NY
National Provider Identifier
1497924062
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090197 Issued in NY
Practice address
200 E 3Rd St
Jamestown, NY 14701-5433
Phone
(716) 661-8330
NPI assigned
Feb 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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 080653-1 NY
Clinical Social Worker 1041C0700X 090197 NY Primary

Addresses

Primary practice location

200 E 3Rd St
Jamestown, NY 14701-5433

Mailing address

2 Academy St RM 201
Mayville, NY 14757-1050
Phone (716) 753-4104

Other names 1

  • Tamie Gates Former name

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
I20230307000117 NY Practitioner - Clinical Social Worker 3678946092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080653-1NYMDSocial Worker
090197NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Chautauqua - a Mun Corp CurrentSince Nov 11, 2022 Accepting new patients
County of Chautauqua - a Mun Corp CurrentSince Nov 11, 2022 Accepting new patients

Locations

200 E 3rd St
Ste 5
Jamestown, NY 14701
Phone (716) 661-8330

200 E 3rd St
Jamestown, NY 14701
Phone (716) 661-8330

3 N Erie St
Mayville, NY 14757

2 Academy St
Rm 201
Mayville, NY 14757
Phone (716) 753-4104

Organizations & group practices 2

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1497924062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ACADEMY ST RM 201",
            "city": "MAYVILLE",
            "state": "NY",
            "postal_code": "147571050",
            "telephone_number": "716-753-4104",
            "fax_number": "716-753-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 3RD ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015433",
            "telephone_number": "716-661-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "TAMIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080653-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMIE",
            "last_name": "GATES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.