Individual provider Active NPI

Joann Mazzocchi-Fleitz, LCSW-R

  • Social Worker
  • Poughquag, NY
National Provider Identifier
1851540991
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
069872-1 Issued in NY
Practice address
19 Rose St
Poughquag, NY 12570-5733
Phone
(845) 227-6574
Fax
(845) 227-7450
NPI assigned
Sep 12, 2008
Last updated
Sep 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 069872-1 NY Primary

Addresses

Primary practice location

19 Rose St
Poughquag, NY 12570-5733

Mailing address

19 Rose St
Poughquag, NY 12570-5733
Phone (845) 227-6574

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
I20240417003619 NY Practitioner - Clinical Social Worker 2365881729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Great Oaks Blvd
Suite 101
Albany, NY 12203-7924
Phone (518) 250-4706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069872NYMDMental Health Counselor
069872-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Connections Together, LCSW, PLLC CurrentSince Jan 22, 2024 Accepting new patients
Creating Connections Together LCSW PLLC Social Worker Past Accepting new patients
Creating Connections Together, LCSW, PLLC Past Accepting new patients
Creating Connections Together, LCSW,PLLC Past Accepting new patients

Locations

100 Great Oaks Blvd
Ste 101
Albany, NY 12203
Phone (518) 250-4706

100 Great Oaks Blvd
Ste 117A
Albany, NY 12203
Phone (518) 250-4706

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1851540991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ROSE ST",
            "city": "POUGHQUAG",
            "state": "NY",
            "postal_code": "125705733",
            "telephone_number": "845-227-6574",
            "fax_number": "845-227-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ROSE ST",
            "city": "POUGHQUAG",
            "state": "NY",
            "postal_code": "125705733",
            "telephone_number": "845-227-6574",
            "fax_number": "845-227-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOCCHI-FLEITZ",
        "first_name": "JOANN",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "069872-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughquag, NY

Sources for this page

Verify at the official NPI Registry.