Active NPI
Tanya M Enigk, LCSW-R
- Social Worker
- Vernon, NY
National Provider Identifier
1962570820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 73071092
- Practice address
- 5457 East Seneca Street
Vernon, NY 13476 - Phone
- (315) 762-2144
- Fax
- (315) 363-9286
- NPI assigned
- Nov 30, 2006
- Last updated
- Apr 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 73071092 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 0710921 | NY |
Addresses
Primary practice location
5457 East Seneca Street
Vernon, NY 13476
Mailing address
332 Robertson Rd
Sherrill, NY 13461-1367
Phone (315) 762-2144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0720007192 | Medicaid | NY |
Other names 1
- Miss Tanya M Gilleece
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
| License | State | Type | Specialty |
|---|---|---|---|
| 73071092 | NY | MD | Social Worker |
| 071092 | NY | MD | Clinical Social Worker |
| 0710921 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nysarc 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, 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": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1962570820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 ROBERTSON RD",
"city": "SHERRILL",
"state": "NY",
"postal_code": "134611367",
"telephone_number": "315-762-2144",
"fax_number": "315-363-9286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5457 EAST SENECA STREET",
"city": "VERNON",
"state": "NY",
"postal_code": "13476",
"telephone_number": "315-762-2144",
"fax_number": "315-363-9286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENIGK",
"first_name": "TANYA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "73071092",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "0710921",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0720007192",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TANYA",
"last_name": "GILLEECE",
"middle_name": "M",
"prefix": "MISS",
"credential": "LCSW-R",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.