Individual provider Active NPI

Cerene L Prince, LCSW

  • Clinical Social Worker
  • Saint Albans, NY
National Provider Identifier
1700397494
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083198-1 Issued in NY
Practice address
18915 119TH Ave
Saint Albans, NY 11412-3322
Phone
(917) 922-4538
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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 083198-1 NY Primary

Addresses

Primary practice location

18915 119TH Ave
Saint Albans, NY 11412-3322

Mailing address

18915 119TH Ave
Saint Albans, NY 11412-3322
Phone (917) 922-4538

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
I20180813001946 NY Practitioner - Clinical Social Worker 8325396096 Practice locations: Saint Albans, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Saint Albans, NY 11412
Phone (516) 200-1174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083198-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orchard Blue Counseling Services LCSW, PLLC Clinical CurrentSince Jan 24, 2021 Accepting new patients

Locations

19019 Linden Blvd
Ste A
Saint Albans, NY 11412

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1700397494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18915 119TH AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123322",
            "telephone_number": "917-922-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18915 119TH AVE",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123322",
            "telephone_number": "917-922-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "CERENE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083198-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, NY

Sources for this page

Verify at the official NPI Registry.