Individual provider Active NPI

Devan Fitzpatrick, LMSW

  • Clinical Social Worker
  • Mattituck, NY
National Provider Identifier
1689264285
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100803 Issued in NY
Practice address
7555 Main Rd
Mattituck, NY 11952-1516
Phone
(631) 298-8642
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 100803 NY Primary

Addresses

Primary practice location

7555 Main Rd
Mattituck, NY 11952-1516

Mailing address

790 Park Ave
Huntington, NY 11743-4516
Phone (631) 427-3700

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
I20260211002562 NY Practitioner - Clinical Social Worker 8123507993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

7555 Main Rd
Mattituck, NY 11952-1516
Phone (631) 298-8642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100803NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Oct 31, 2025 Accepting new patients

Locations

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

7555 Main Rd
Mattituck, NY 11952
Phone (631) 298-1678

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": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1689264285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434516",
            "telephone_number": "631-427-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 MAIN RD",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119521516",
            "telephone_number": "631-298-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "DEVAN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattituck, NY

Sources for this page

Verify at the official NPI Registry.