Individual provider Active NPI

Mary Carol Dearing, LCSW-R

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1710271093
Registry record updated Jun 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R033004-1 Issued in NY
Practice address
5500 Main St
Suite207
Williamsville, NY 14221-6755
Phone
(716) 633-6900
Fax
(716) 633-6902
NPI assigned
Jun 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2011

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 R033004-1 NY Primary

Addresses

Primary practice location

5500 Main St
Suite207
Williamsville, NY 14221-6755

Mailing address

48 Howard Ave
Williamsville, NY 14221-5428
Phone (716) 998-9263

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R033004-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1710271093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 HOWARD AVE",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215428",
            "telephone_number": "716-998-9263",
            "fax_number": "716-633-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST",
            "address_2": "SUITE207",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216755",
            "telephone_number": "716-633-6900",
            "fax_number": "716-633-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARING",
        "first_name": "MARY CAROL",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-04",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R033004-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.