Benjamin McCormack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089257 Issued in NY

Practice address

4 Wyndon Rd
Ballston Lake, NY 12019-2527

Phone

(518) 952-9206

NPI assigned

Sep 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment NPD
• New Heights LCSW PLLC

  • Clinical Social Worker
  • Clifton Park, NY
  • NPI 1083295372
  NPD Authorized official

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1629587266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WYNDON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WYNDON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192527",
            "telephone_number": "518-952-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "BENJAMIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "098010",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felix Luis Martinez Jr., LMSW
• Julissa Martinez, LMHC-D, NCC, CASAC
• Martins Foods of South Burlington LLC
• Wendy Ann Mason, LCSW-R
• Jill Marie McClain, SLP-CCC
• Jennifer McGetrick, PA
• Christine O'Brien Miceli, M.S., PT.
• Amanda Payton Mody, M.S.ED, R.N.
• Jessica Marie Moriarty, L.AC.
• Suzanne Morrison, LCSW

• Clinical Social Worker in Ballston Lake, NY
• Providers in Ballston Lake, 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 Dec 14, 2021; 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.