Individual provider Active NPI

Charles Sciavolino, LCSW

  • Clinical Social Worker
  • Saratoga, NY
National Provider Identifier
1639391139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-029032-1 Issued in NY
Practice address
30 Crescent Ave.
Saratoga, NY 12866
Phone
(518) 584-3600
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 R-029032-1 NY Primary

Addresses

Primary practice location

30 Crescent Ave.
Saratoga, NY 12866

Mailing address

30 Crescent Ave.
Saratoga, NY 12866

Other identifiers 1

IdentifierTypeStateIssuer
131974OtherNYVALUE OPTIONS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190129002927 NY Practitioner - Clinical Social Worker 4486991478 Practice locations: Delmar, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Delaware Ave
Delmar, NY 12054-1227
Phone (518) 506-6748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-029032-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara F Pats PHD Psychologist PLLC PastSince Feb 22, 2015 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639391139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CRESCENT AVE.",
            "city": "SARATOGA",
            "state": "NY",
            "postal_code": "12866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CRESCENT AVE.",
            "city": "SARATOGA",
            "state": "NY",
            "postal_code": "12866",
            "telephone_number": "518-584-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIAVOLINO",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-029032-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "131974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, NY

Sources for this page

Verify at the official NPI Registry.