Individual provider Active NPI

Melanie A Cavrell, LCSW-R

  • Clinical Social Worker
  • Liberty, NY
National Provider Identifier
1568680767
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-025957-1 Issued in NY
Practice address
76 Nature Lake Rd Ofc
Liberty, NY 12754
Phone
(845) 250-4086
NPI assigned
Apr 23, 2007
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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 R-025957-1 NY Primary

Addresses

Primary practice location

76 Nature Lake Rd Ofc
Liberty, NY 12754

Mailing address

PO Box 34
Fallsburg, NY 12733-0034
Phone (845) 250-4086

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
I20180724003015 NY Practitioner - Clinical Social Worker 7719234533 Practice locations: Liberty, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-025957-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1568680767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "FALLSBURG",
            "state": "NY",
            "postal_code": "127330034",
            "telephone_number": "845-250-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NATURE LAKE RD OFC",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-250-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVRELL",
        "first_name": "MELANIE",
        "middle_name": "A",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-025957-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

Verify at the official NPI Registry.