Individual provider Active NPI

Maria Anastasia Granda, LCSW

  • Clinical Social Worker
  • West Hurley, NY
National Provider Identifier
1841949336
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073810-1 Issued in NY
Practice address
222 State Route 375
West Hurley, NY 12491-5632
Phone
(518) 221-1251
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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 073810-1 NY Primary

Addresses

Primary practice location

222 State Route 375
West Hurley, NY 12491-5632

Mailing address

222 State Route 375
West Hurley, NY 12491-5632
Phone (518) 221-1251

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
I20230816003814 NY Practitioner - Clinical Social Worker 9335501709 Practice locations: West Hurley, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 State Route 375
West Hurley, NY 12491-5632
Phone (518) 221-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073810NYMDSocial Worker
073810-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1841949336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATE ROUTE 375",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124915632",
            "telephone_number": "518-221-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATE ROUTE 375",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124915632",
            "telephone_number": "518-221-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDA",
        "first_name": "MARIA",
        "middle_name": "ANASTASIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073810-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hurley, NY

Sources for this page

Verify at the official NPI Registry.