Active NPI
Kristin Alice Tooley, LCSW-R
- Clinical Social Worker
- Watertown, NY
National Provider Identifier
1871671933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PO54147
- Practice address
- 1351 Washington St
Watertown, NY 13601-4531 - Phone
- (315) 785-3783
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PO54147 | NY | Primary |
Addresses
Primary practice location
1351 Washington St
Watertown, NY 13601-4531
Mailing address
900 Salina St
Watertown, NY 13601-3844
Phone (315) 489-9718
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120430000003 | NY | Practitioner - Clinical Social Worker | 5799947271 | Practice locations: Watertown, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO54147 | NY | MD | Clinical Social Worker |
| 054147 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871671933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 SALINA ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136013844",
"telephone_number": "315-489-9718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 WASHINGTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136014531",
"telephone_number": "315-785-3783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOOLEY",
"first_name": "KRISTIN",
"middle_name": "ALICE",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PO54147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.