Sherry Mederos, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

070356-1 Issued in NY

Practice address

830 Howard Ave
Copiague, NY 11726-3910

Phone

(631) 766-0489

Fax

(631) 466-3344

NPI assigned

Oct 1, 2008

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

Other identifiers 1

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

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1639320351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 HOWARD AVE",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263910",
            "telephone_number": "631-766-0489",
            "fax_number": "631-466-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HOWARD AVE",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263910",
            "telephone_number": "631-766-0489",
            "fax_number": "631-466-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEROS",
        "first_name": "SHERRY",
        "name_prefix": "Ms.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070356-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02791091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Kevon Mayo
• Meghan C McCauley
• Dawn McDonald, MA CCC-SLP, TSSLD-BE
• Daphne McLean-Lewis
• Brittney Ashley McPherson, LCSW
• Christopher Mehm, DPT
• Ana Virginia Mera, MENTAL HEALTH COUNSE
• Marissa Jean Mercurio, MSW
• Brenda Mickens, LPN
• Jeanelle Miles

• Clinical Social Worker in Copiague, NY
• Providers in Copiague, 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 Mar 17, 2015; 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.