Thomas John Durham, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069779 Issued in NY

Practice address

18 Douglas Dr
Canandaigua, NY 14424-1018

Phone

(585) 703-8942

NPI assigned

Oct 17, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mosaic Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ilion, NY
  • NPI 1528428208
  Medicare reassignment NPD
• Mosaic Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rushville, NY
  • NPI 1336984178
  NPD
• Mosaic Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Utica, NY
  • NPI 1649587627
  NPD
• Mosaic Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rushville, NY
  • NPI 1912225236
  NPD (past)

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1639454101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 DOUGLAS DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241018",
            "telephone_number": "585-703-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 DOUGLAS DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241018",
            "telephone_number": "585-703-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Driscoll, N.P.
• Parker Drumm
• Patrick Ducey, LMHC
• Matthew Georg Duell
• Marvin Duncan, LCSW
• Eckerd Corporation
• Eckerd Corporation
• Carla Jeanne Eggleston, RNFA
• Kelly L Eldredge
• Kristn Anne Eldredge, LMT

• Clinical Social Worker in Canandaigua, NY
• Providers in Canandaigua, 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 Oct 17, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.