Active NPI
Sarah Jean Petroccitto, LCSW
- Clinical Social Worker
- Gardiner, NY
National Provider Identifier
1942574264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0736761
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0736761 | NY | MD | Clinical Social Worker |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0736761 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary 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.