Individual provider Active NPI

Margo Harris, LCSW

  • Clinical Social Worker
  • Cornwall, NY
National Provider Identifier
1538218086
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO24604-1 Issued in NY
Practice address
21 Willow Ave
Cornwall, NY 12518-1429
Phone
(845) 534-4732
Fax
(845) 534-4732
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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 RO24604-1 NY Primary

Addresses

Primary practice location

21 Willow Ave
Cornwall, NY 12518-1429

Mailing address

21 Willow Ave
Cornwall, NY 12518-1429
Phone (845) 534-4732

Other identifiers 2

IdentifierTypeStateIssuer
0018253OtherNYGHI-BMP
135855OtherNYVALUE 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
I20070831000036 NY Practitioner - Clinical Social Worker 0446343800 Practice locations: Cornwall, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Willow Ave
Cornwall, NY 12518-1429
Phone (845) 534-4732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO24604-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1538218086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WILLOW AVE",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181429",
            "telephone_number": "845-534-4732",
            "fax_number": "845-534-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WILLOW AVE",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181429",
            "telephone_number": "845-534-4732",
            "fax_number": "845-534-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARGO",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO24604-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-BMP",
            "identifier": "0018253",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "135855",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornwall, NY

Sources for this page

Verify at the official NPI Registry.