Individual provider Active NPI

Maggie A. Willis, L.C.S.W.

  • Clinical Social Worker
  • Schenectady, NY
National Provider Identifier
1508886631
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071587 Issued in NY
Practice address
600 Franklin St
Schenectady, NY 12305-2100
Phone
(518) 372-7031
Fax
(518) 372-7064
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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 071587 NY Primary

Addresses

Primary practice location

600 Franklin St
Schenectady, NY 12305-2100

Mailing address

PO Box 31094
Hartford, CT 06150-1094
Phone (518) 952-8140

Other identifiers 1

IdentifierTypeStateIssuer
01420800MedicaidNY

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
I20040525001605 NY Practitioner - Clinical Social Worker 2668453762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roman Catholic Diocese of Albany NyGroup PAC ID 3274433065, 9 clinicians

Practice addresses (Care Compare)

790 Lancaster St
Albany, NY 12203-1541
Phone (518) 489-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071587NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roman Catholic Diocese of Albany Ny CurrentSince Jan 13, 2010 Accepting new patients

Locations

790 Lancaster St
Albany, NY 12203
Phone (518) 489-4431

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1508886631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31094",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061501094",
            "telephone_number": "518-952-8140",
            "fax_number": "518-952-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FRANKLIN ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123052100",
            "telephone_number": "518-372-7031",
            "fax_number": "518-372-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MAGGIE",
        "middle_name": "A.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.