Individual provider Active NPI

Patricia M Klein, LMSW

  • Social Worker
  • Penfield, NY
National Provider Identifier
1801192877
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
058279 Issued in NY
Practice address
441 Penbrooke Dr Ste 1
Penfield, NY 14526-2046
Phone
(585) 398-8835
Fax
(585) 398-7376
NPI assigned
Feb 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 058279 NY Primary

Addresses

Primary practice location

441 Penbrooke Dr Ste 1
Penfield, NY 14526-2046

Mailing address

212 W Main St
Riverhead, NY 11901-2841
Phone (631) 369-7800

Other practice location 1

6539 Anthony Dr Ste A
Victor, NY 14564-1441
Phone (585) 398-8835

Other practice location 2

212 W Main St
Riverhead, NY 11901-2841
Phone (631) 369-7800

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
I20180524002270 NY Practitioner - Clinical Social Worker 0244595189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058279NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Counseling Center,LTD CurrentSince Apr 16, 2018 Accepting new patients

Locations

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

Organizations & group practices 1

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1801192877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012841",
            "telephone_number": "631-369-7800",
            "fax_number": "631-369-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 PENBROOKE DR STE 1",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262046",
            "telephone_number": "585-398-8835",
            "fax_number": "585-398-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6539 Anthony Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Victor",
            "state": "NY",
            "postal_code": "145641441",
            "country_code": "US",
            "telephone_number": "585-398-8835",
            "fax_number": "585-398-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 W Main St",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012841",
            "country_code": "US",
            "telephone_number": "631-369-7800",
            "fax_number": "631-369-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "058279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.