Active NPI
Bernadette Martello, LCSW
- Clinical Social Worker
- Amawalk, NY
National Provider Identifier
1699832154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R027855
- Practice address
- 17 Watergate Dr
Amawalk, NY 10501-1102 - Phone
- (914) 962-0457
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R027855 | NY | Primary |
Addresses
Primary practice location
17 Watergate Dr
Amawalk, NY 10501-1102
Mailing address
17 Watergate Dr
Amawalk, NY 10501-1102
Phone (914) 962-0457
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 564304 | Other | NY | EMPIRE PLAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027855 | NY | MD | Psychologist |
| R027855 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699832154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 WATERGATE DR",
"city": "AMAWALK",
"state": "NY",
"postal_code": "105011102",
"telephone_number": "914-962-0457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WATERGATE DR",
"city": "AMAWALK",
"state": "NY",
"postal_code": "105011102",
"telephone_number": "914-962-0457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTELLO",
"first_name": "BERNADETTE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R027855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE PLAN",
"identifier": "564304",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amawalk, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.