Individual provider Active NPI

Sherri Michele Flournoy, LCSW R

  • Clinical Social Worker
  • Hollis, NY
National Provider Identifier
1508905621
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0532581 Issued in NY
Practice address
87 - 86 188TH Street
1 Level
Hollis, NY 11423
Phone
(917) 863-6910
NPI assigned
Feb 5, 2007
Last updated
Apr 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 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 R0532581 NY Primary

Addresses

Primary practice location

87 - 86 188TH Street
1 Level
Hollis, NY 11423

Mailing address

1150 Ossipee Road
West Hempstead, NY 11552
Phone (516) 536-1835

Other names 1

  • Sherri Michele Pettiford 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
I20070228000629 NY Practitioner - Clinical Social Worker 2769584366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0532581NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. CurrentSince Aug 8, 2016 Accepting new patients

Locations

10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone 7182756010 ext. 244

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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, 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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1508905621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 OSSIPEE ROAD",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "11552",
            "telephone_number": "516-536-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 - 86 188TH STREET",
            "address_2": "1 LEVEL",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "11423",
            "telephone_number": "917-863-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOURNOY",
        "first_name": "SHERRI",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "LCSW R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0532581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRI",
            "last_name": "PETTIFORD",
            "middle_name": "MICHELE",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollis, NY

Sources for this page

Verify at the official NPI Registry.