Individual provider Active NPI

Catherine Fredella, LCSW-R

  • Clinical Social Worker
  • Binghamton, NY
National Provider Identifier
1811060072
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047780-1 Issued in NY
Practice address
46 Riverside Dr Ofc 7
Binghamton, NY 13905-4511
Phone
(607) 759-6468
Fax
(607) 798-0861
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 R047780-1 NY Primary

Addresses

Primary practice location

46 Riverside Dr Ofc 7
Binghamton, NY 13905-4511

Mailing address

42 Cleveland Ave
Binghamton, NY 13905-3226
Phone (607) 759-6468

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
I20100330000208 NY Practitioner - Clinical Social Worker 2961538988 Practice locations: Binghamton, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

38 -42 Front St
Binghamton, NY 13905-4712
Phone (607) 759-6468

46 Riverside Dr
Suite 7
Binghamton, NY 13905-4511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047780-1NYMDClinical Social Worker
047780NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1811060072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CLEVELAND AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139053226",
            "telephone_number": "607-759-6468",
            "fax_number": "607-798-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 RIVERSIDE DR OFC 7",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054511",
            "telephone_number": "607-759-6468",
            "fax_number": "607-798-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDELLA",
        "first_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.