Individual provider Active NPI

Beverly Lipson, L.C.S.W.

  • Clinical Social Worker
  • Suffern, NY
National Provider Identifier
1033129093
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR05553 Issued in NY
Practice address
2 Kings Gate Rd
Suffern, NY 10901-3111
Phone
(845) 357-6690
Fax
(845) 368-1726
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR05553 NY Primary
Clinical Social Worker 1041C0700X SC13636 NJ

Addresses

Primary practice location

2 Kings Gate Rd
Suffern, NY 10901-3111

Mailing address

2 Kings Gate Rd
Suffern, NY 10901-3111
Phone (845) 357-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000227 NY Practitioner - Clinical Social Worker 2062684921 Practice locations: Suffern, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Kings Gate Rd
Suffern, NY 10901-3111
Phone (845) 357-6690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015553NYMDPsychologist
SC13636NJMDClinical Social Worker
PR05553NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033129093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KINGS GATE RD",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109013111",
            "telephone_number": "845-357-6690",
            "fax_number": "845-368-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 KINGS GATE RD",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109013111",
            "telephone_number": "845-357-6690",
            "fax_number": "845-368-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSON",
        "first_name": "BEVERLY",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR05553",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC13636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.