Individual provider Active NPI

Danielle Buckleman, LMSW, CASAC

  • Social Worker
  • Medford, NY
National Provider Identifier
1508152497
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
080654 Issued in NY
Practice address
10 Winged Foot Dr
Medford, NY 11763-1804
Phone
(631) 617-2919
NPI assigned
Jun 20, 2011
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 24082 NY
Social Worker 104100000X 080654 NY Primary

Addresses

Primary practice location

10 Winged Foot Dr
Medford, NY 11763-1804

Mailing address

10 Winged Foot Dr
Medford, NY 11763-1804
Phone (631) 617-2919

Other names 1

  • Danielle Gibbons 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
I20250110000532 NY Practitioner - Clinical Social Worker 4789112392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brittni Traina, LCSW PLLCGroup PAC ID 9537535554, 10 clinicians

Practice addresses (Care Compare)

2050 N Country Rd
Wading River, NY 11792-1634
Phone (631) 379-5637

39 Forest Ave
Glen Cove, NY 11542-2107
Phone (631) 379-5637

53 Franklin Ave
Lynbrook, NY 11563-1237
Phone (631) 379-5637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24082NYMDAddiction (Substance Use Disorder) Counselor
080654NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brittni Traina, LCSW, PLLC CurrentSince Jan 6, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1508152497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WINGED FOOT DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631804",
            "telephone_number": "631-617-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WINGED FOOT DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631804",
            "telephone_number": "631-617-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEMAN",
        "first_name": "DANIELLE",
        "credential": "LMSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "24082",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "GIBBONS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.