Individual provider Active NPI

Theresa Ann Norris, MSSW, LCSW-R

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1871735928
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R032141-1 Issued in NY
Practice address
1076 Forest Ave
Staten Island, NY 10310-2405
Phone
(718) 979-0673
NPI assigned
Apr 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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 R032141-1 NY Primary

Addresses

Primary practice location

1076 Forest Ave
Staten Island, NY 10310-2405

Mailing address

1076 Forest Ave
Staten Island, NY 10310-2405
Phone (718) 979-0673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R032141-1NYMDClinical Social Worker
032141NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Psychological Services PC Past Accepting new patients
Heartland Medical Services, P.C. Past Accepting new patients

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": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1871735928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102405",
            "telephone_number": "718-979-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102405",
            "telephone_number": "718-979-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSSW, LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R032141-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.