Individual provider Active NPI

Stephen Velasquez, MSW, CISW, LCSW

  • Social Worker
  • Cave Springs, AR
National Provider Identifier
1982972584
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0-23249-1B Issued in VI
Practice address
504 Rustic Creek LN
Cave Springs, AR 72718-8820
Phone
(914) 768-6110
NPI assigned
Dec 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9830-C AR
Social Worker 104100000X 0-23249-1B VI Primary

Addresses

Primary practice location

504 Rustic Creek LN
Cave Springs, AR 72718-8820

Mailing address

504 Rustic Creek LN
Cave Springs, AR 72718-8820
Phone (914) 768-3026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200210000290 AR Practitioner - Clinical Social Worker 3577999655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

504 Rustic Creek LN
Cave Springs, AR 72718-8820
Phone (914) 768-3026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0-23249-1BVIMDSocial Worker

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.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1982972584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 RUSTIC CREEK LN",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "727188820",
            "telephone_number": "914-768-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 RUSTIC CREEK LN",
            "city": "CAVE SPRINGS",
            "state": "AR",
            "postal_code": "727188820",
            "telephone_number": "914-768-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "MSW, CISW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-09",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "9830-C",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VI",
            "license": "0-23249-1B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cave Springs, AR

Sources for this page

Verify at the official NPI Registry.