Individual provider Active NPI

Yvonne Marie Pratt, LCSWR

  • Clinical Social Worker
  • Holtsville, NY
National Provider Identifier
1861573636
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R053148-1 Issued in NY
Practice address
755 Waverly Ave
Holtsville, NY 11742-1190
Phone
(631) 758-7827
Fax
(631) 758-7827
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 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 R053148-1 NY Primary

Addresses

Primary practice location

755 Waverly Ave
Holtsville, NY 11742-1190

Mailing address

2 Frank St
East Patchogue, NY 11772-5908
Phone (631) 758-7827

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
I20090115000462 NY Practitioner - Clinical Social Worker 0446313514 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

Practice addresses (Care Compare)

2 Frank St
East Patchogue, NY 11772-5908
Phone (631) 758-7827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R053148-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind & Body Theraputics,Inc. CurrentSince Oct 28, 2008 Accepting new patients

Locations

755 Waverly Ave
Holtsville, NY 11742
Phone (631) 654-7011

Organizations & group practices 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1861573636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FRANK ST",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725908",
            "telephone_number": "631-758-7827",
            "fax_number": "631-758-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WAVERLY AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421190",
            "telephone_number": "631-758-7827",
            "fax_number": "631-758-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "YVONNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053148-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holtsville, NY

Sources for this page

Verify at the official NPI Registry.