Individual provider Active NPI

Terrence A Sanders, LCSW-R

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1659470128
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
058371-1 Issued in NY
Practice address
114 Clinton St
Binghamton, NY 13905-2212
Phone
(607) 797-0680
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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 058371-1 NY Primary

Addresses

Primary practice location

114 Clinton St
Binghamton, NY 13905-2212

Mailing address

114 Clinton St
Binghamton, NY 13905-2212
Phone (607) 797-0680

Other identifiers 1

IdentifierTypeStateIssuer
058371-1OtherNYLCSW

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
I20070104000140 NY Practitioner - Clinical Social Worker 3072513639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058371-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Southern Tier Inc Clinical CurrentSince Oct 1, 2017 Accepting new patients
Greater Binghamton Health Center Past Accepting new patients

Locations

3001 E Main St
Endwell, NY 13760
Phone (607) 754-2660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1659470128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CLINTON ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139052212",
            "telephone_number": "607-797-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CLINTON ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139052212",
            "telephone_number": "607-797-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "TERRENCE",
        "middle_name": "A",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "058371-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "058371-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.