Individual provider Active NPI

Holly Perue, LMSW

  • Social Worker
  • Fort Edward, NY
National Provider Identifier
1578137642
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
066285-1 Issued in NY
Practice address
11 Windcrest Dr
Fort Edward, NY 12828-1309
Phone
(518) 888-2057
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 066285-1 NY Primary

Addresses

Primary practice location

11 Windcrest Dr
Fort Edward, NY 12828-1309

Mailing address

11 Windcrest Dr
Fort Edward, NY 12828-1309
Phone (518) 888-2057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
066285-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1578137642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WINDCREST DR",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281309",
            "telephone_number": "518-888-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WINDCREST DR",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128281309",
            "telephone_number": "518-888-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUE",
        "first_name": "HOLLY",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "066285-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Edward, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.