Individual provider Active NPI

Sarah Jean Petroccitto, LCSW

  • Clinical Social Worker
  • Gardiner, NY
National Provider Identifier
1942574264
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0736761 Issued in NY
Practice address
1061 Bruynswick Rd
Gardiner, NY 12525-5106
Phone
(845) 255-9161
NPI assigned
Mar 5, 2012
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0736761NYMDClinical Social Worker

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0736761 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

1061 Bruynswick Rd
Gardiner, NY 12525-5106

Mailing address

1061 Bruynswick Rd
Gardiner, NY 12525-5106
Phone (845) 255-9161

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2012.

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1942574264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 BRUYNSWICK RD",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255106",
            "telephone_number": "845-255-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 BRUYNSWICK RD",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255106",
            "telephone_number": "845-255-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCCITTO",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0736761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardiner, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.