Individual provider Active NPI

Shelby Kaufmann, LCSW

  • Clinical Social Worker
  • Queensbury, NY
National Provider Identifier
1720626674
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
095358 Issued in NY
Practice address
25 Willowbrook Rd
Queensbury, NY 12804-5882
Phone
(518) 926-7100
NPI assigned
Dec 11, 2019
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 095358 NY Primary

Addresses

Primary practice location

25 Willowbrook Rd
Queensbury, NY 12804-5882

Mailing address

140 Beekman St # 1
Saratoga Springs, NY 12866-3025
Phone (847) 420-5258

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
I20230613002834 NY Practitioner - Clinical Social Worker 8921465501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2155 State Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services North, Inc. CurrentSince May 8, 2023 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince May 8, 2023 Accepting new patients

Locations

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 563-8206

25 Willowbrook Rd
Queensbury, NY 12804
Phone (518) 793-9156

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1720626674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BEEKMAN ST # 1",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663025",
            "telephone_number": "847-420-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-926-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "SHELBY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.