Active NPI
Theresa Marie Dearie, LCSW
- Clinical Social Worker
- Endicott, NY
National Provider Identifier
1912330127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 072032-1
- Practice address
- 202 E Main St
Endicott, NY 13760-4817 - Phone
- (607) 754-2660
- Fax
- (607) 754-0769
- NPI assigned
- Aug 12, 2013
- Last updated
- Aug 12, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 072032-1 | NY | Primary |
Addresses
Primary practice location
202 E Main St
Endicott, NY 13760-4817
Mailing address
PO Box 8901
Endicott, NY 13760
Phone (607) 239-0366
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
| License | State | Type | Specialty |
|---|---|---|---|
| 072032-1 | NY | MD | Clinical Social Worker |
| 072032 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376265600000",
"number": "1912330127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8901",
"city": "ENDICOTT",
"state": "NY",
"postal_code": "13760",
"telephone_number": "607-239-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E MAIN ST",
"city": "ENDICOTT",
"state": "NY",
"postal_code": "137604817",
"telephone_number": "607-754-2660",
"fax_number": "607-754-0769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARIE",
"first_name": "THERESA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-12",
"last_updated": "2013-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "072032-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Endicott, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.