Individual provider Active NPI

Renay Lynne Bevins Pence, LCSWR

  • Clinical Social Worker
  • New Windsor, NY
National Provider Identifier
1972645364
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0326471 Issued in NY
Practice address
557 Blooming Grove Tpke
New Windsor, NY 12553-7843
Phone
(845) 561-4219
Fax
(845) 561-3644
NPI assigned
Feb 13, 2007
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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 R0326471 NY Primary

Addresses

Primary practice location

557 Blooming Grove Tpke
New Windsor, NY 12553-7843

Mailing address

PO Box 4037
New Windsor, NY 12553
Phone (845) 561-4219

Other practice location 1

91 Bloomingrove Turnpike
New Windsor, NY 12553
Phone (845) 561-4219

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
I20071105000419 NY Practitioner - Clinical Social Worker 7012963689 Practice locations: New Windsor, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

557 Blooming Grove Tpke
New Windsor, NY 12553-7843
Phone (845) 561-4219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0326471NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1972645364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4037",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "12553",
            "telephone_number": "845-561-4219",
            "fax_number": "845-561-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125537843",
            "telephone_number": "845-561-4219",
            "fax_number": "845-561-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Bloomingrove Turnpike",
            "address_purpose": "LOCATION",
            "city": "New Windsor",
            "state": "NY",
            "postal_code": "12553",
            "country_code": "US",
            "telephone_number": "845-561-4219",
            "fax_number": "845-561-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEVINS PENCE",
        "first_name": "RENAY",
        "middle_name": "LYNNE",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0326471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

Verify at the official NPI Registry.