Individual provider Active NPI

Katherine Roessel, LCSW-R

  • Clinical Social Worker
  • Carmel, NY
National Provider Identifier
1689855371
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055019-1 Issued in NY
Practice address
95 Gleneida Ave
Carmel, NY 10512-1235
Phone
(845) 592-0484
Fax
(845) 231-6078
NPI assigned
Nov 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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 R055019-1 NY Primary

Addresses

Primary practice location

95 Gleneida Ave
Carmel, NY 10512-1235

Mailing address

6 Presidential Way
Hopewell Junction, NY 12533-5618
Phone (845) 592-0484

Other practice location 1

6 Presidential Way
Hopewell Junction, NY 12533-5618
Phone (845) 592-0484

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
I20031204000907 NY Practitioner - Clinical Social Worker 7012812837 Practice locations: Hopewell Junction, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Presidential Way
Hopewell Junction, NY 12533-5618
Phone (845) 592-0484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055019-1NYMDClinical Social Worker
055019NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1689855371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PRESIDENTIAL WAY",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125335618",
            "telephone_number": "845-592-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 GLENEIDA AVE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105121235",
            "telephone_number": "845-592-0484",
            "fax_number": "845-231-6078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Presidential Way",
            "address_purpose": "LOCATION",
            "city": "Hopewell Junction",
            "state": "NY",
            "postal_code": "125335618",
            "country_code": "US",
            "telephone_number": "845-592-0484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROESSEL",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055019-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, NY

Sources for this page

Verify at the official NPI Registry.