Individual provider Active NPI

Deborah Sobell, LCSW

  • Clinical Social Worker
  • Baldwinsville, NY
National Provider Identifier
1629154703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR017312-1 Issued in NY
Practice address
12 W Genesee St
Baldwinsville, NY 13027-1105
Phone
(315) 638-0988
Fax
(315) 251-2603
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PR017312-1 NY Primary

Addresses

Primary practice location

12 W Genesee St
Baldwinsville, NY 13027-1105

Mailing address

12 W Genesee St
Baldwinsville, NY 13027-1105
Phone (315) 638-0988

Other identifiers 4

IdentifierTypeStateIssuer
047378OtherNYVALUEOPTIONS
392980OtherNYMVP
11239627OtherNYCAQH
7496260OtherNYGHI

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

LicenseStateTypeSpecialty
PR017312-1NYMDClinical Social Worker
017312NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629154703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W GENESEE ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271105",
            "telephone_number": "315-638-0988",
            "fax_number": "315-251-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W GENESEE ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271105",
            "telephone_number": "315-638-0988",
            "fax_number": "315-251-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBELL",
        "first_name": "DEBORAH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR017312-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "047378",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "392980",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11239627",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7496260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.