Individual provider Active NPI

Rosemary Ann Collins, M.S.W.

  • Clinical Social Worker
  • Fayetteville, NY
National Provider Identifier
1841365772
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
041022-R Issued in NY
Practice address
7 Lyndon Rd
Fayetteville, NY 13066-1015
Phone
(315) 233-1212
Fax
(315) 708-0041
NPI assigned
Nov 24, 2006
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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 041022-R NY Primary

Addresses

Primary practice location

7 Lyndon Rd
Fayetteville, NY 13066-1015

Mailing address

7 Lyndon Rd
Fayetteville, NY 13066-1015
Phone (315) 445-4880

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
041022-RNYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1841365772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LYNDON RD",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661015",
            "telephone_number": "315-445-4880",
            "fax_number": "315-708-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LYNDON RD",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661015",
            "telephone_number": "315-233-1212",
            "fax_number": "315-708-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ROSEMARY",
        "middle_name": "ANN",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "041022-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.