Individual provider Active NPI

Katherine Carey Carnicelli

  • Clinical Social Worker
  • Scarsdale, NY
National Provider Identifier
1851981906
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077898 Issued in NY
Practice address
14 Dunham Rd
Scarsdale, NY 10583-6006
Phone
(914) 497-0234
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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 077898 NY Primary

Addresses

Primary practice location

14 Dunham Rd
Scarsdale, NY 10583-6006

Mailing address

14 Dunham Rd # Q
Scarsdale, NY 10583-6006

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL computer Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20210225002648 NY Practitioner - Clinical Social Worker 6608281506 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077898NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC Clinical CurrentSince Dec 25, 2020 Accepting new patients
Che Senior Psychological Services, PC Clinical CurrentSince Dec 25, 2020 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 2

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1851981906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DUNHAM RD # Q",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105836006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 DUNHAM RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105836006",
            "telephone_number": "914-497-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNICELLI",
        "first_name": "KATHERINE",
        "middle_name": "CAREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "endpointDescription": "computer",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "computer",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "computer",
            "address_1": "14 Dunham Rd",
            "city": "Scarsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105836006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.