Individual provider Active NPI

Yolanda Carrion, LCSW

  • Clinical Social Worker
  • Freeport, NY
National Provider Identifier
1669489456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R027743-1 Issued in NY
Practice address
429 Atlantic Ave
4A
Freeport, NY 11520-5256
Phone
(516) 378-5059
Fax
(516) 546-5051
NPI assigned
Aug 2, 2006
Sex
Female
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 R027743-1 NY Primary

Addresses

Primary practice location

429 Atlantic Ave
4A
Freeport, NY 11520-5256

Mailing address

429 Atlantic Ave
4A
Freeport, NY 11520-5256
Phone (516) 378-5059

Other identifiers 1

IdentifierTypeStateIssuer
02026117MedicaidNY

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
I20041029000806 NY Practitioner - Clinical Social Worker 9739141904 Practice locations: Freeport, 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)

429 Atlantic Ave
Suite 4a
Freeport, NY 11520-5256
Phone (516) 378-5059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R027743-1NYMDClinical Social Worker
027743NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669489456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 ATLANTIC AVE",
            "address_2": "4A",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205256",
            "telephone_number": "516-378-5059",
            "fax_number": "516-546-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 ATLANTIC AVE",
            "address_2": "4A",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205256",
            "telephone_number": "516-378-5059",
            "fax_number": "516-546-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRION",
        "first_name": "YOLANDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R027743-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02026117",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.