Individual provider Active NPI

Shirley Ann Stevens, LMSW

  • Social Worker
  • Remsen, NY
National Provider Identifier
1659247203
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
127940 Issued in NY
Practice address
11154 Countryman Rd
Remsen, NY 13438-4223
Phone
(315) 240-5577
NPI assigned
Oct 13, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 127940 NY Primary

Addresses

Primary practice location

11154 Countryman Rd
Remsen, NY 13438-4223

Mailing address

3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256

Other practice location 1

3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
127940NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Mental Health CurrentSince Oct 21, 2025 Accepting new patients

Locations

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

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": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1659247203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 BELL BLVD STE 203",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612097",
            "telephone_number": "718-504-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11154 COUNTRYMAN RD",
            "city": "REMSEN",
            "state": "NY",
            "postal_code": "134384223",
            "telephone_number": "315-240-5577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Bell Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113612097",
            "country_code": "US",
            "telephone_number": "718-504-9256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "127940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Remsen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.