Active NPI
Penny Wilbur-Harris, LCSW
- School Social Worker
- South Setauket, NY
National Provider Identifier
1619077153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 15 Brookfield LN
South Setauket, NY 11720-1444 - Phone
- (631) 553-8469
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R027333 | NY | |
| School Social Worker | 1041S0200X | NY | Primary |
Addresses
Primary practice location
15 Brookfield LN
South Setauket, NY 11720-1444
Mailing address
15 Brookfield LN
South Setauket, NY 11720-1444
Phone (631) 553-8469
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145126 | Other | NY | VALUE OPTIONS |
| IP322152 | Other | NY | EMPIRE BC/BS |
| 11238224 | Other | MO | CAQH |
| 4281184 | Other | TX | AETNA |
| P75660 | Other | CT | OXFORD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R027333 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1619077153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BROOKFIELD LN",
"city": "SOUTH SETAUKET",
"state": "NY",
"postal_code": "117201444",
"telephone_number": "631-553-8469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BROOKFIELD LN",
"city": "SOUTH SETAUKET",
"state": "NY",
"postal_code": "117201444",
"telephone_number": "631-553-8469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBUR-HARRIS",
"first_name": "PENNY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R027333",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "145126",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "IP322152",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11238224",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4281184",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P75660",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.