Individual provider Active NPI

Sandra L Kaelin, LCSW

  • Clinical Social Worker
  • Utica, NY
National Provider Identifier
1962838300
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080969 Issued in NY
Practice address
1500 Genesee St
Utica, NY 13502-5104
Phone
(315) 735-9501
Fax
(315) 735-9769
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 080969 NY Primary

Addresses

Primary practice location

1500 Genesee St
Utica, NY 13502-5104

Mailing address

1500 Genesee St
Utica, NY 13502-5104
Phone (315) 735-9501

Other identifiers 1

IdentifierTypeStateIssuer
080969OtherNYLICENSE NUMBER

Other names 1

  • Ms. Sandra L Kaelin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140801000113 NY Practitioner - Clinical Social Worker 2466678198 Reassigns benefits to 2 organizations
I20210728004136 FL Practitioner - Clinical Social Worker 2466678198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians
Che Behavioral Health Services of Florida, P.a.Group PAC ID 5698185775, 31 clinicians

Practice addresses (Care Compare)

135 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (800) 275-3243

6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Oct 19, 2022 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Oct 19, 2022 Accepting new patients
Che Behavioral Health Services of Florida, P.a. Clinical CurrentSince Oct 19, 2022 Accepting new patients

Locations

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1962838300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025104",
            "telephone_number": "315-735-9501",
            "fax_number": "315-735-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025104",
            "telephone_number": "315-735-9501",
            "fax_number": "315-735-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAELIN",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "080969",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "KAELIN",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.