Individual provider Active NPI

Geobany Rodriguez

  • Clinical Social Worker
  • Tarrytown, NY
National Provider Identifier
1811444672
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
094915 Issued in NY
Practice address
22 Church St # 2
Tarrytown, NY 10591-4806
Phone
(917) 757-9612
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MA
Clinical Social Worker 1041C0700X 094915 NY Primary

Addresses

Primary practice location

22 Church St # 2
Tarrytown, NY 10591-4806

Mailing address

22 Church St # 2
Tarrytown, NY 10591-4806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
094915NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Charles Mental Health Research & Training Foundation, Inc Clinical PastSince Dec 22, 2019 Accepting new patients
Cambridge Psychiatric Services, Inc PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 2

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1811444672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHURCH ST # 2",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CHURCH ST # 2",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914806",
            "telephone_number": "917-757-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GEOBANY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.