Active NPI
Richard Allen Bennett, L.C.S.W.
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1023024288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 069664-1
- Practice address
- 45 Wildwood LN
Smithtown, NY 11787-3452 - Phone
- (631) 724-3145
- Fax
- (631) 724-5044
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 069664-1 | NY | Primary |
Addresses
Primary practice location
45 Wildwood LN
Smithtown, NY 11787-3452
Mailing address
45 Wildwood LN
Smithtown, NY 11787-3452
Phone (631) 724-3145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 3, 2017 through Nov 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069664 | NY | MD | Clinical Social Worker |
| 069664-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023024288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 WILDWOOD LN",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873452",
"telephone_number": "631-724-3145",
"fax_number": "631-724-5044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 WILDWOOD LN",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873452",
"telephone_number": "631-724-3145",
"fax_number": "631-724-5044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "RICHARD",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "069664-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.