Individual provider Active NPI

Sarah Tillotson, LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1699970541
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
078948 Issued in NY
Practice address
819 S Salina St
Syracuse, NY 13202-3527
Phone
(315) 476-7921
Fax
(315) 474-1448
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X 078948 NY Primary

Addresses

Primary practice location

819 S Salina St
Syracuse, NY 13202-3527

Mailing address

819 S Salina St
Syracuse, NY 13202-3527
Phone (315) 476-7921

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
I20180507000580 NY Order and Referring Only - Clinical Social Worker 4082846282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078948NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intuitive Psychotherapy, LCSW, PLLC Current Accepting new patients

Locations

24 Copeland Ave
Homer, NY 13077
Phone (315) 558-8821

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1699970541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023527",
            "telephone_number": "315-476-7921",
            "fax_number": "315-474-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023527",
            "telephone_number": "315-476-7921",
            "fax_number": "315-474-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "SARAH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "078948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.