Individual provider Active NPI

Celine Stillman, LCSW-R

  • Clinical Social Worker
  • Nyack, NY
National Provider Identifier
1861673634
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R076599-01 Issued in NY
Practice address
779 Route 9W S
Nyack, NY 10960-5020
Phone
(917) 519-9657
Fax
(845) 365-6330
NPI assigned
Nov 20, 2007
Last updated
Oct 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073534-1 NY
Clinical Social Worker 1041C0700X R076599-01 NY Primary

Addresses

Primary practice location

779 Route 9W S
Nyack, NY 10960-5020

Mailing address

779 Route 9W S
Nyack, NY 10960-5020
Phone (917) 519-9657

Other identifiers 1

IdentifierTypeStateIssuer
00073534MedicaidNY

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
I20090422000353 NY Practitioner - Clinical Social Worker 3577610948 Reassigns benefits to 1 organization
Practice locations: Nyack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 N Broadway
Nyack, NY 10960-2018
Phone (917) 519-9567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073534-1NYMDClinical Social Worker
R076599-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Celine Stillman LCSW PC Clinical CurrentSince May 1, 2022 Accepting new patients

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, 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": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1861673634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 ROUTE 9W S",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109605020",
            "telephone_number": "917-519-9657",
            "fax_number": "845-365-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 ROUTE 9W S",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109605020",
            "telephone_number": "917-519-9657",
            "fax_number": "845-365-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLMAN",
        "first_name": "CELINE",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073534-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R076599-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00073534",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

Verify at the official NPI Registry.