Individual provider Active NPI

Kacey Helen Sornberger, LCSW

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1962423079
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077578 Issued in NY
Practice address
401 New Karner Rd
Albany, NY 12205-3854
Phone
(518) 431-1650
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 077578 NY Primary
Clinical Social Worker 1041C0700X 111291 MA

Addresses

Primary practice location

401 New Karner Rd
Albany, NY 12205-3854

Mailing address

28 Witte Rd
Albany, NY 12203-4933
Phone (617) 417-2022

Other practice location 1

6072 State Farm Rd
Guilderland, NY 12084-9532
Phone (518) 431-1650

Other identifiers 1

IdentifierTypeStateIssuer
1302272MedicaidMA

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

LicenseStateTypeSpecialty
077578NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Cove Human Services, Inc Past Accepting new patients

Organizations & group practices 1

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1962423079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WITTE RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122034933",
            "telephone_number": "617-417-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEW KARNER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122053854",
            "telephone_number": "518-431-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6072 State Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120849532",
            "country_code": "US",
            "telephone_number": "518-431-1650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORNBERGER",
        "first_name": "KACEY",
        "middle_name": "HELEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077578",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302272",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.