Individual provider Active NPI

Cassandra L Eberhard-Leal, LCSW

  • Clinical Social Worker
  • Goshen, NY
National Provider Identifier
1972936193
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084877 Issued in NY
Practice address
53 Gibson Rd
Goshen, NY 10924
Phone
(845) 291-0200
NPI assigned
Aug 12, 2013
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X NY
Clinical Social Worker 1041C0700X 084877 NY Primary

Addresses

Primary practice location

53 Gibson Rd
Goshen, NY 10924

Mailing address

53 Gibson Rd
Goshen, NY 10924-6709

Other practice location 1

200 Route 32 Ste 206
Central Valley, NY 10917-3663
Phone (845) 527-2321

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
084877NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1972936193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 GIBSON RD",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GIBSON RD",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Route 32 Ste 206",
            "address_purpose": "LOCATION",
            "city": "Central Valley",
            "state": "NY",
            "postal_code": "109173663",
            "country_code": "US",
            "telephone_number": "845-527-2321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERHARD-LEAL",
        "first_name": "CASSANDRA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.