Active NPI
Karen Andrus, LCSW-R
- Clinical Social Worker
- Watkins Glen, NY
National Provider Identifier
1619376928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 075231
- Practice address
- 106 S Perry St
Watkins Glen, NY 14891-1615 - Phone
- (607) 535-8282
- Fax
- (607) 535-8284
- NPI assigned
- Aug 22, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 075231 | NY | Primary |
Addresses
Primary practice location
106 S Perry St
Watkins Glen, NY 14891-1615
Mailing address
106 S Perry St
Watkins Glen, NY 14891-1615
Phone (607) 535-8282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 075231 | Medicaid | NY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075231 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408665600000",
"number": "1619376928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 S PERRY ST",
"city": "WATKINS GLEN",
"state": "NY",
"postal_code": "148911615",
"telephone_number": "607-535-8282",
"fax_number": "607-535-8284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 S PERRY ST",
"city": "WATKINS GLEN",
"state": "NY",
"postal_code": "148911615",
"telephone_number": "607-535-8282",
"fax_number": "607-535-8284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRUS",
"first_name": "KAREN",
"credential": "LCSW-R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-22",
"last_updated": "2014-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "075231",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "075231",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watkins Glen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.