Active NPI
Conetta Embodu Natasha Brantch
- Clinical Social Worker
- Saint Albans, NY
National Provider Identifier
1508464900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 085956-1
- Practice address
- 18535 Jordan Ave
Saint Albans, NY 11412-2305 - Phone
- (917) 435-8070
- NPI assigned
- Oct 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 085956-1 | NY | Primary |
Addresses
Primary practice location
18535 Jordan Ave
Saint Albans, NY 11412-2305
Mailing address
18535 Jordan Ave
Saint Albans, NY 11412-2305
Phone (917) 435-8070
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | VerizonFios |
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 |
|---|---|---|---|
| 085956-1 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cenb Solutions LLC | Clinical | Current | Accepting new patients |
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- conettabrantch@tdh.allscriptsdirect.net
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": "1602806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1508464900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18535 JORDAN AVE",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122305",
"telephone_number": "917-435-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18535 JORDAN AVE",
"city": "SAINT ALBANS",
"state": "NY",
"postal_code": "114122305",
"telephone_number": "917-435-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANTCH",
"first_name": "CONETTA",
"middle_name": "EMBODU NATASHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-16",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "085956-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "VerizonFios",
"affiliation": "N",
"address_1": "18535 Jordan Ave",
"city": "Saint Albans",
"state": "NY",
"country_code": "US",
"postal_code": "114122305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Albans, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.