Active NPI
Suzanne Gavin, LCSW
- Social Worker
- Great Neck, NY
National Provider Identifier
1043366792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 00073797
- Practice address
- 1 Barstow Rd
Suite P24
Great Neck, NY 11021-3540 - Phone
- (516) 236-3116
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 00073797 | NY | Primary |
Addresses
Primary practice location
1 Barstow Rd
Suite P24
Great Neck, NY 11021-3540
Mailing address
1 Barstow Rd
Great Neck, NY 11021-3540
Phone (516) 236-3116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00073797 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00073797 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1043366792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BARSTOW RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110213540",
"telephone_number": "516-236-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARSTOW RD",
"address_2": "SUITE P24",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110213540",
"telephone_number": "516-236-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIN",
"first_name": "SUZANNE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "00073797",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00073797",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.