KRISTIN MARIE REDELL LCSW, NPI 1477643716 — AMHERST (NY)

NPI 1477643716

13+ Years Experience Individual

KRISTIN MARIE REDELL LCSW

10/16/2006
PROVIDER ENUMERATION DATE
07.06.2011
LAST UPDATE DATE
1477643716
NPI NUMBER

About KRISTIN MARIE REDELL

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

KRISTIN MARIE REDELL is a provider established in AMHERST, NY. The NPI number of KRISTIN MARIE REDELL is 1477643716 and was assigned on 10/16/2006. The practitioners primary taxonomy code is: 104100000X with license number: 72895 NY .

Mailing address

  • City: AMHERST
  • State: NY
  • Postal code: 142283604
  • Phone: 7166893333
  • Fax: 7166899695
  • Address: 85 BRYANT WOODS S

Primary Practice Address

  • Region : AMHERST, NY
  • NPI : 1477643716
  • Phone : 7166893333
  • Fax : 7166899695
  • Postalcode : 142283604
  • Address : 85 BRYANT WOODS S

Additional identifiers

  • Identifier: 506354006
  • Code / Type : 1 - other
  • Identifier state : NY
  • Identifier issuer: COMMUNITY BLUE

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 30241501
  • Code / Type : 1 - other
  • Identifier state : NY
  • Identifier issuer : UNIVERA

Provider taxonomy - Social Worker

  • Taxonomy code: 104100000X
  • License number: 72895
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Contacts:

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  • KRISTIN MARIE REDELL LCSW
  • Address : 85 BRYANT WOODS S
  • Region : AMHERST, NY
  • NPI : 1477643716
  • Phone : 7166893333
  • Fax : 7166899695
  • Postalcode : 142283604

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address85 BRYANT WOODS S
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameAMHERST
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code142283604
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7166893333
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7166899695
The fax number associated with the location address of the provider being identified.
NPI1477643716
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1104100000X
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Provider Enumeration Date10/16/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.06.2011
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)KRISTIN MARIE REDELL
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address85 BRYANT WOODS S
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameAMHERST
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code142283604
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7166893333
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number7166899695
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1104100000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Social Worker
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Provider License Number 172895
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1506354006
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1NY
Other Provider Identifier State #1
Other Provider Identifier Issuer 1COMMUNITY BLUE
Other Provider Identifier Issuer #1
Other Provider Identifier 230241501
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NY
Other Provider Identifier State #2
Other Provider Identifier Issuer 2UNIVERA
Other Provider Identifier Issuer #2
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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