Individual provider Active NPI

Deborah Lynn Mungavin, LCSW

  • Clinical Social Worker
  • Cortlandt Manor, NY
National Provider Identifier
1659656700
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R073139-1 Issued in NY
Practice address
300 Croton Ave
Cortlandt Manor, NY 10567-5221
Phone
(914) 739-2823
Fax
(914) 739-8535
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 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 R073139-1 NY Primary

Addresses

Primary practice location

300 Croton Ave
Cortlandt Manor, NY 10567-5221

Mailing address

15 Sycamore Rd
Mahopac, NY 10541-1414
Phone (914) 263-2707

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
R073139-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1659656700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SYCAMORE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105411414",
            "telephone_number": "914-263-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CROTON AVE",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105675221",
            "telephone_number": "914-739-2823",
            "fax_number": "914-739-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNGAVIN",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R073139-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortlandt Manor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.