Individual provider Active NPI

Hollace Merrill Beer, LCSW

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1003071911
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-025826 Issued in NY
Practice address
23 Grissom Ave
Staten Island, NY 10314-4908
Phone
(718) 698-6903
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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 R-025826 NY Primary

Addresses

Primary practice location

23 Grissom Ave
Staten Island, NY 10314-4908

Mailing address

23 Grissom Ave
Staten Island, NY 10314-4908
Phone (718) 698-6903

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
R-025826NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1003071911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 GRISSOM AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144908",
            "telephone_number": "718-698-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 GRISSOM AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144908",
            "telephone_number": "718-698-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEER",
        "first_name": "HOLLACE",
        "middle_name": "MERRILL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-025826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.