Carol Ann Slattery, EDD, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078466 Issued in NY

Practice address

620 Route 303
Blauvelt, NY 10913-1170

Phone

(845) 353-2730

Fax

(845) 353-2358

NPI assigned

Sep 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carolann.slattery.d1.p2@direct.sdv.nextgenshare.com
• Direct secure messaging: carolann.slattery.p2@direct.sdv.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Samaritan Daytop Health

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1518641752
  Medicare reassignment NPD
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Blauvelt, NY
  • NPI 1134240344
  NPD (past)

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1619258324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75A LAKE RD STE 132",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109202323",
            "telephone_number": "845-825-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ROUTE 303",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131170",
            "telephone_number": "845-353-2730",
            "fax_number": "845-353-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "EDD, LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyamal K Sarkar, RPH
• Todd David Scott, CASAC- T
• Natalie Joy Sierra
• Christina Sirera, FNP
• Rania Skaf, PMHNP
• Chevonne Small-Washington, LPN
• Denise Smith, BS, LCCE, FACCE
• South Orangetown Central School District
• St.Dominic'S Home
• St.Dominic'S Home

• Clinical Social Worker in Blauvelt, NY
• Providers in Blauvelt, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.