Individual provider Active NPI

Dorothy Nollman, MSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1508810896
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR013650-1 Issued in NY
Practice address
118 Landing Ave
Smithtown, NY 11787-2713
Phone
(631) 366-4431
NPI assigned
May 20, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR013650-1 NY Primary

Addresses

Primary practice location

118 Landing Ave
Smithtown, NY 11787-2713

Mailing address

118 Landing Ave
Smithtown, NY 11787-2713
Phone (631) 366-4431

Other identifiers 2

IdentifierTypeStateIssuer
64078OtherNYVYTRA
7492876OtherNYVALUE OPTIONS

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
I20111102000551 NY Practitioner - Clinical Social Worker 9739352055 Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

118 Landing Ave
Smithtown, NY 11787-2713
Phone (631) 366-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR013650-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508810896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 LANDING AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872713",
            "telephone_number": "631-366-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 LANDING AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872713",
            "telephone_number": "631-366-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLMAN",
        "first_name": "DOROTHY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR013650-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "64078",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "7492876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.