Ontario County
NPI 1003802190ActiveOrganization· Social Worker· Canandaigua, NY
Social Worker in Canandaigua, New York, registered in NPPES in September 2005. The authorized official on file is Jessica Mitchell, PHD, Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003802190 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 23, 2005 |
| Last updated in NPPES | Apr 1, 2021 |
| Certified by provider | Apr 1, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 6879100A | NY |
| Psychologist | 103T00000X | 6879100A | NY |
| Psychologist, Clinical | 103TC0700X | 6879100A | NY |
| Social Worker, Clinical | 1041C0700X | 6879100A | NY |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | 6879100A | NY |
| Nurse Practitioner | 363L00000X | 6879100A | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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