Individual provider Active NPI

Ellen Brandon, L.C.S.W.

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1881091122
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086389-1 Issued in NY
Practice address
10 McKown Rd
Albany, NY 12203-3496
Phone
(518) 689-0244
NPI assigned
Dec 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 086389-1 NY Primary

Addresses

Primary practice location

10 McKown Rd
Albany, NY 12203-3496

Mailing address

10 McKown Rd
Albany, NY 12203-3496
Phone (518) 689-0244

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
I20180827003378 NY Practitioner - Clinical Social Worker 9234488057 Reassigns benefits to 1 organization
Practice locations: Delmar, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Burhans PL
Delmar, NY 12054-1201
Phone (518) 289-0602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086389NYMDSocial Worker
086389-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Behavioral Health Ipa PLLC CurrentSince Jul 1, 2018 Accepting new patients
Joseph Ippolito Clinical Past Accepting new patients

Locations

10 McKown Rd
Ste 102
Albany, NY 12203
Phone (518) 689-0244

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": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1881091122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MCKOWN RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033496",
            "telephone_number": "518-689-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MCKOWN RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033496",
            "telephone_number": "518-689-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "ELLEN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086389-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.