Individual provider Active NPI

Eileen F. Rutter, LCSW-R

  • Clinical Social Worker
  • Valley Cottage, NY
National Provider Identifier
1689725806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PRO25294-1 Issued in NY
Practice address
56 Ridge Rd
Valley Cottage, NY 10989-2527
Phone
(845) 268-4590
NPI assigned
Jan 15, 2007
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 PRO25294-1 NY Primary

Addresses

Primary practice location

56 Ridge Rd
Valley Cottage, NY 10989-2527

Mailing address

56 Ridge Rd
Valley Cottage, NY 10989-2527
Phone (845) 268-4590

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
I20130425000032 NY Practitioner - Clinical Social Worker 2860638525 Practice locations: Valley Cottage, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 Ridge Rd
Valley Cottage, NY 10989-2527
Phone (845) 268-4590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025294NYMDClinical Psychologist
PRO25294-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689725806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892527",
            "telephone_number": "845-268-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 RIDGE RD",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892527",
            "telephone_number": "845-268-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTER",
        "first_name": "EILEEN",
        "middle_name": "F.",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PRO25294-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Cottage, NY

Sources for this page

Verify at the official NPI Registry.