Individual provider Active NPI

Nathaniel Smith, LCSW-R

  • Clinical Social Worker
  • Pleasantville, NY
National Provider Identifier
1992718415
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWL-392732 Issued in NY
Practice address
351 Manville Rd Ste 101
Pleasantville, NY 10570-2166
Phone
(917) 538-3532
Fax
(844) 965-9672
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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 SWL-392732 NY Primary

Addresses

Primary practice location

351 Manville Rd Ste 101
Pleasantville, NY 10570-2166

Mailing address

79 Sleepy Hollow Rd
Sleepy Hollow, NY 10591-1518
Phone (917) 538-3532

Other names 1

  • Mr. Nathaniel Smith-Marrone Professional name

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
I20070823000004 NY Practitioner - Clinical Social Worker 0042302903 Practice locations: Pleasantville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

351 Manville Rd
Suite 101
Pleasantville, NY 10570-2152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWL-392732NYMDClinical Social Worker
055856NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1992718415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SLEEPY HOLLOW RD",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911518",
            "telephone_number": "917-538-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 MANVILLE RD STE 101",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702166",
            "telephone_number": "917-538-3532",
            "fax_number": "844-965-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "SWL-392732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATHANIEL",
            "last_name": "SMITH-MARRONE",
            "prefix": "MR.",
            "credential": "LCSW-R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pleasantville, NY

Sources for this page

Verify at the official NPI Registry.