Individual provider Active NPI

David Powers, LCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1770904641
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085562 Issued in NY
Practice address
11 Route 111
Smithtown, NY 11787-3739
Phone
(631) 920-8351
NPI assigned
Dec 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 085562 NY Primary

Addresses

Primary practice location

11 Route 111
Smithtown, NY 11787-3739

Mailing address

11 Route 111
Smithtown, NY 11787-3739
Phone (631) 920-8351

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
I20210601000900 NY Practitioner - Clinical Social Worker 5193124808 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085562NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Feb 26, 2021 Accepting new patients
Aldad Medical PC CurrentSince Oct 1, 2023 Accepting new patients
Mercy Medical Center CurrentSince Feb 26, 2021 Accepting new patients
Mercy Medical Center Current Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

506 Stewart Ave
Village of Garden City, NY 11530
Phone (516) 705-3400

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Organizations & group practices 4

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1770904641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873739",
            "telephone_number": "631-920-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873739",
            "telephone_number": "631-920-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "DAVID",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.