Active NPI
Thomas W Callaghan, LCSW-R
- Clinical Social Worker
- Trumansburg, NY
National Provider Identifier
1760641302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 071091
- Practice address
- 35 South St
Trumansburg, NY 14886-9530 - Phone
- (607) 387-4337
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 071091 | NY | Primary |
Addresses
Primary practice location
35 South St
Trumansburg, NY 14886-9530
Mailing address
35 South St
Trumansburg, NY 14886-9530
Phone (607) 256-6239
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090306000566 | NY | Practitioner - Clinical Social Worker | 2769548213 | Practice locations: Ithaca, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
108 N Cayuga St
Suite 4
Ithaca, NY 14850-4346
Phone (607) 256-6239
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352160000000",
"number": "1760641302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SOUTH ST",
"city": "TRUMANSBURG",
"state": "NY",
"postal_code": "148869530",
"telephone_number": "607-256-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 SOUTH ST",
"city": "TRUMANSBURG",
"state": "NY",
"postal_code": "148869530",
"telephone_number": "607-387-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAGHAN",
"first_name": "THOMAS",
"middle_name": "W",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2012-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "071091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumansburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.