Individual provider Active NPI

Janice Guay Benjamin, LMSW

  • Social Worker
  • Queensbury, NY
National Provider Identifier
1962568378
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
20-4919991 Issued in NY
Practice address
138 Quaker Rd
Queensbury, NY 12804-1789
Phone
(518) 792-2303
NPI assigned
Dec 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 20-4919991 NY Primary

Addresses

Primary practice location

138 Quaker Rd
Queensbury, NY 12804-1789

Mailing address

138 Quaker Rd
Queensbury, NY 12804-1789
Phone (518) 743-1327

Other identifiers 1

IdentifierTypeStateIssuer
20-4919991OtherNYLICENSED MASTER SOCIAL WO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180530001816 NY Practitioner - Clinical Social Worker 4486919180 Practice locations: Queensbury, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

123 Dixon Rd
Queensbury, NY 12804-2133
Phone (518) 798-2088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20-4919991NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Cross Roads Psychology PLLC PastSince Jan 1, 1999 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962568378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041789",
            "telephone_number": "518-743-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041789",
            "telephone_number": "518-792-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "JANICE",
        "middle_name": "GUAY",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "20-4919991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASTER SOCIAL WO",
            "identifier": "20-4919991",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.