Active NPI
Tina M Mansky, LCSW
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1508086505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0339861
- Practice address
- 269 F East Main Street
Smithtown, NY 11787 - Phone
- (631) 543-1063
- Fax
- (631) 543-4288
- NPI assigned
- May 1, 2007
- Sex
- Female
- 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 | R0339861 | NY | Primary |
Addresses
Primary practice location
269 F East Main Street
Smithtown, NY 11787
Mailing address
89 Laurel Drive
Smithtown, NY 11787-4243
Phone (631) 543-4288
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6276549 | Other | NY | UNITED BEHAVIORAL HEALTH |
| 7400592 | Other | NY | GHI |
| 4462481 | Other | NY | AETNA BEHAVIORAL HEALTH |
| 1000046079 | Other | NY | BEACON HEALTH AFFINITY |
| P2813431 | Other | NY | OXFORD HEALTH PLANS |
| 145461 | Other | NY | VALUE OPTIONS |
| N9231 | Other | NY | EMPIRE BLUECROSS BLUESHIE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R0339861 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508086505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 LAUREL DRIVE",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874243",
"telephone_number": "631-543-4288",
"fax_number": "631-543-4288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 F EAST MAIN STREET",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "11787",
"telephone_number": "631-543-1063",
"fax_number": "631-543-4288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSKY",
"first_name": "TINA",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0339861",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "6276549",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "7400592",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "4462481",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH AFFINITY",
"identifier": "1000046079",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "P2813431",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "145461",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUECROSS BLUESHIE",
"identifier": "N9231",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, 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.