Individual provider Active NPI

Deborah Ellen Knapp, LCSW

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1831484468
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075442 Issued in NY
Practice address
267 East Main Street
BLDG. B, Suite 21-B
Smithtown, NY 11787
Phone
(631) 655-4495
NPI assigned
Jun 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 075442 NY
Mental Health Counselor 101YM0800X 075442 NY
Professional Counselor 101YP2500X 075442 NY
Clinical Social Worker 1041C0700X 075442 NY Primary

Addresses

Primary practice location

267 East Main Street
BLDG. B, Suite 21-B
Smithtown, NY 11787

Mailing address

267 E Main St
BLG B, Ste 21-B
Smithtown, NY 11787-2874
Phone (631) 209-7655

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
I20190424001590 NY Practitioner - Clinical Social Worker 4789926668 Practice locations: Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

267 E Main St
BLDG. B Suite 21 B
Smithtown, NY 11787-2989

267 E Main St
BLG B Suite 21a
Smithtown, NY 11787-2885

267 E Main St BLDG B
21B Dba/Contemplative Counseling Psychother
Smithtown, NY 11787-2989
Phone (631) 655-4495

27 Neil Dr
Smithtown, NY 11787-2885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075442NYMDClinical Social Worker
062791NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Savi Mushiyev MD PC Current Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1831484468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E MAIN ST",
            "address_2": "BLG B, STE 21-B",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872874",
            "telephone_number": "631-209-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 EAST MAIN STREET",
            "address_2": "BLDG. B, SUITE 21-B",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-655-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "DEBORAH",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-11",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "075442",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "075442",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "075442",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.