Individual provider Active NPI

Brenda Yarcag, CSWR

  • Clinical Social Worker
  • Canton, NY
National Provider Identifier
1770649733
Registry record updated Nov 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0507011 Issued in NY
Practice address
123 Main St
Canton, NY 13617-1415
Phone
(315) 379-9162
Fax
(315) 379-9162
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2018

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 R0507011 NY Primary

Addresses

Primary practice location

123 Main St
Canton, NY 13617-1415

Mailing address

123 Main St
Canton, NY 13617-1415
Phone (315) 244-3078

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
I20120215000343 NY Practitioner - Clinical Social Worker 3476711839 Practice locations: Canton, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

123 Main St
Canton, NY 13617-1415
Phone (315) 244-3078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0507011NYMDClinical Social Worker
050701NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541203200000",
    "number": "1770649733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171415",
            "telephone_number": "315-244-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171415",
            "telephone_number": "315-379-9162",
            "fax_number": "315-379-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARCAG",
        "first_name": "BRENDA",
        "credential": "CSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2018-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0507011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.