Individual provider Active NPI

Carla Fay Kandel, LCSWR

  • Clinical Social Worker
  • Spring Valley, NY
National Provider Identifier
1699865428
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR021076-1 Issued in NY
Practice address
4 Shady Ridge LN
Spring Valley, NY 10977-1130
Phone
(845) 354-6387
Fax
(845) 354-6387
NPI assigned
Oct 13, 2006
Sex
Male
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 PR021076-1 NY Primary

Addresses

Primary practice location

4 Shady Ridge LN
Spring Valley, NY 10977-1130

Mailing address

4 Shady Ridge LN
Spring Valley, NY 10977-1130
Phone (845) 354-6387

Other identifiers 2

IdentifierTypeStateIssuer
236505OtherNYMAGELLAN
7672237OtherNYAETNA

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
I20110325000573 NY Practitioner - Clinical Social Worker 2062695299 Practice locations: Spring Valley, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4 Shady Ridge LN
Spring Valley, NY 10977-1130
Phone (845) 354-6387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR021076-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699865428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHADY RIDGE LN",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771130",
            "telephone_number": "845-354-6387",
            "fax_number": "845-354-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHADY RIDGE LN",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771130",
            "telephone_number": "845-354-6387",
            "fax_number": "845-354-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDEL",
        "first_name": "CARLA",
        "middle_name": "FAY",
        "name_prefix": "Mrs.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR021076-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "236505",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7672237",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

Verify at the official NPI Registry.