Individual provider Active NPI

Sarah Elizabeth Fitzsimmons, LCSW

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1558815324
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087589 Issued in NY
Practice address
65 Ashburton Ave
Yonkers, NY 10701-2930
Phone
(914) 729-4916
NPI assigned
Aug 10, 2016
Last updated
Apr 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 096330-1 NY
Clinical Social Worker 1041C0700X 087589-1 NY
Clinical Social Worker 1041C0700X 087589 NY Primary

Addresses

Primary practice location

65 Ashburton Ave
Yonkers, NY 10701-2930

Mailing address

1538 E Boulevard
Peekskill, NY 10566-4819
Phone (914) 729-4916

Other practice location 1

5 Grace Church St
Port Chester, NY 10573-4911
Phone (914) 272-5276

Other identifiers 1

IdentifierTypeStateIssuer
05553833MedicaidNY

Other names 1

  • Ms. Sarah Elizabeth Tubbs Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Psychologytoday.com Direct

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
I20190226000937 NY Practitioner - Clinical Social Worker 4284973868 Reassigns benefits to 1 organization
Practice locations: Yonkers, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087589-1NYMDMental Health Counselor
096330-1NYMDSocial Worker
087589NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Dyckman Andrus Memorial, Inc. CurrentSince Jan 5, 2019 Accepting new patients

Locations

19 Greenridge Ave
White Plains, NY 10605
Phone (914) 949-7680

1156 N Broadway
Yonkers, NY 10701
Phone (914) 965-3700

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, 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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1558815324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 E BOULEVARD",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105664819",
            "telephone_number": "914-729-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 ASHBURTON AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012930",
            "telephone_number": "914-729-4916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Grace Church St",
            "address_purpose": "LOCATION",
            "city": "Port Chester",
            "state": "NY",
            "postal_code": "105734911",
            "country_code": "US",
            "telephone_number": "914-272-5276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZSIMMONS",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096330-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087589-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05553833",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Psychologytoday.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "65 ASHBURTON AVE",
            "city": "YONKERS",
            "state": "NY",
            "country_code": "US",
            "postal_code": "107012930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "TUBBS",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.