Individual provider Active NPI

Karen O'Brien, LCSW-R

  • Clinical Social Worker
  • Bellport, NY
National Provider Identifier
1023190501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
066989-1 Issued in NY
Practice address
11 Farber Drive
Unit D
Bellport, NY 11713
Phone
(631) 286-0700
Fax
(631) 286-0688
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 066989-1 NY Primary

Addresses

Primary practice location

11 Farber Drive
Unit D
Bellport, NY 11713

Mailing address

11 Farber Drive
Unit D
Bellport, NY 11713
Phone (631) 286-0700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
066989-1NYMDClinical Social Worker
066989NYMDPharmacist
074243NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Development Corporation PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023190501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FARBER DRIVE",
            "address_2": "UNIT D",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "11713",
            "telephone_number": "631-286-0700",
            "fax_number": "631-286-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FARBER DRIVE",
            "address_2": "UNIT D",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "11713",
            "telephone_number": "631-286-0700",
            "fax_number": "631-286-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KAREN",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "066989-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellport, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.