Individual provider Active NPI

Stephanie Anne Woodworth, LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1689409187
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
124634-01 Issued in NY
Practice address
1045 James St Ste 100
Syracuse, NY 13203-2758
Phone
(315) 472-4471
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 124634-01 NY Primary

Addresses

Primary practice location

1045 James St Ste 100
Syracuse, NY 13203-2758

Mailing address

113 Randall Ter
North Syracuse, NY 13212-2404
Phone (315) 657-2638

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
124634-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1689409187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 RANDALL TER",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122404",
            "telephone_number": "315-657-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032758",
            "telephone_number": "315-472-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWORTH",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "124634-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.