Brendan Sheridan, LCSWR
Individual provider Active NPI Clinical Social Worker · Bearsville, NY
NPI 1689077950 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1689077950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- R080577-1 (NY)
- Practice address
- 163 Wittenberg Rd
Bearsville, NY 12409-5629 - Phone
- (845) 627-4817
- NPI assigned
- Oct 1, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R080577-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R080577-1 | NY | Yes |
| School Social Worker | 1041S0200X | NY |
Addresses
Primary practice location
163 Wittenberg Rd
Bearsville, NY 12409-5629
Mailing address
163 Wittenberg Rd
Bearsville, NY 12409-5629
Phone (845) 627-4817
Other providers in Bearsville, NY
- Carol Ann Kelly
- Paula Jayne Kindos-Carberry
- Amanda E Lehrer
- Jennifer Ruth Mehlich
- John Conrad Satriani
- Elisabeth Werth
All providers in Bearsville, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.