Heather Maria Pudish, LCSW

Individual provider Active NPI Clinical Social Worker · Whitney Point, NY

NPI 1962742585 · NPPES record last updated Jan 13, 2020

Key facts

NPI
1962742585
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089190-01 (NY)
Practice address
10 Keibel Road
Whitney Point Central School District
Whitney Point, NY 13862
Phone
(607) 692-8202
Fax
(607) 692-4434
NPI assigned
Feb 19, 2013
Sex
Female
Sole proprietor
Yes

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.

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
089190-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whitney Point Central School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089190-01 NY Yes

Addresses

Primary practice location

10 Keibel Road
Whitney Point Central School District
Whitney Point, NY 13862

Mailing address

10 Keibel Road
Whitney Point Central School District
Whitney Point, NY 13862
Phone (607) 692-8202

Other identifiers

IdentifierTypeStateIssuer
089190-01MedicaidNY

Other providers in Whitney Point, NY

All providers in Whitney Point, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.