Individual provider Active NPI

Janet Ann Siry, L.C.S.W.

  • Clinical Social Worker
  • East Setauket, NY
National Provider Identifier
1669619433
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076454-1 Issued in NY
Practice address
342 Old Town Rd
East Setauket, NY 11733-3452
Phone
(516) 818-7701
Fax
(631) 828-2652
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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 076454-1 NY Primary

Addresses

Primary practice location

342 Old Town Rd
East Setauket, NY 11733-3452

Mailing address

342 Old Town Rd
East Setauket, NY 11733-3452
Phone (516) 818-7701

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
I20240920003079 NY Practitioner - Clinical Social Worker 2668913344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lutheran Pastoral Counseling Ministry IncGroup PAC ID 0749608032, 5 clinicians

Practice addresses (Care Compare)

132 Jefferson Ave
Mineola, NY 11501-2712
Phone (516) 741-0994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076454-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Pastoral Counseling Ministry Inc CurrentSince Jul 18, 2024 Accepting new patients

Locations

132 Jefferson Ave
Mineola, NY 11501
Phone (516) 741-0994

179 E Main St
Patchogue, NY 11772
Phone (516) 741-0994

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1669619433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 OLD TOWN RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333452",
            "telephone_number": "516-818-7701",
            "fax_number": "631-828-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 OLD TOWN RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333452",
            "telephone_number": "516-818-7701",
            "fax_number": "631-828-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRY",
        "first_name": "JANET",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076454-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.