Individual provider Active NPI

Derek Saunders, LCSW-R

  • Clinical Social Worker
  • Westbury, NY
National Provider Identifier
1912449307
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
055275-1 Issued in NY
Practice address
578 Dartmouth St
Westbury, NY 11590-3419
Phone
(646) 621-6983
NPI assigned
Nov 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 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 055275-1 NY Primary

Addresses

Primary practice location

578 Dartmouth St
Westbury, NY 11590-3419

Mailing address

578 Dartmouth St
Westbury, NY 11590-3419
Phone (646) 621-6983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055275-1NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1912449307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 DARTMOUTH ST",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903419",
            "telephone_number": "646-621-6983",
            "fax_number": "718-795-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 DARTMOUTH ST",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903419",
            "telephone_number": "646-621-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "DEREK",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "055275-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

Verify at the official NPI Registry.