Individual provider Active NPI

Carolyn J Konig, LCSW-R

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1871866707
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078919-1 Issued in NY
Practice address
500 Central Ave
Albany, NY 12206-2213
Phone
(518) 435-9931
NPI assigned
Feb 23, 2012
Last updated
Mar 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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 078919-1 NY Primary

Addresses

Primary practice location

500 Central Ave
Albany, NY 12206-2213

Mailing address

500 Central Ave
Albany, NY 12206-2213
Phone (518) 435-9931

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
I20120516000397 NY Practitioner - Clinical Social Worker 8123281821 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078919-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Equinox Inc CurrentSince Mar 31, 2012 Accepting new patients
Professional Medical Concierge Services, PLLC Clinical CurrentSince Aug 1, 2020 Accepting new patients

Locations

500 Central Ave
Albany, NY 12206
Phone (518) 435-9931

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

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, 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": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1871866707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062213",
            "telephone_number": "518-435-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122062213",
            "telephone_number": "518-435-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIG",
        "first_name": "CAROLYN",
        "middle_name": "J",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078919-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.