Individual provider Active NPI

Edith K Tannar, LCSW CASAC

  • Clinical Social Worker
  • Warwick, NY
National Provider Identifier
1841365228
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P0S39221 Issued in NY
Practice address
18 Jones Rd
Warwick, NY 10990
Phone
(845) 986-0439
Fax
(845) 986-7472
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 P0S39221 NY Primary

Addresses

Primary practice location

18 Jones Rd
Warwick, NY 10990

Mailing address

18 Jones Rd
Warwick, NY 10990
Phone (845) 986-0439

Other identifiers 1

IdentifierTypeStateIssuer
11624563OtherCAQH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P0S39221NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841365228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 JONES RD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "10990",
            "telephone_number": "845-986-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 JONES RD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "10990",
            "telephone_number": "845-986-0439",
            "fax_number": "845-986-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNAR",
        "first_name": "EDITH",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P0S39221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11624563",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.