Individual provider Active NPI

Colleen Michelle Garvey, LCSW

  • Clinical Social Worker
  • Long Beach, NY
National Provider Identifier
1053435107
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO48618-1 Issued in NY
Practice address
26 E Park Ave
Suite 300
Long Beach, NY 11561-3595
Phone
(516) 889-0080
Fax
(516) 785-4289
NPI assigned
Mar 16, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X RO48618-1 NY Primary

Addresses

Primary practice location

26 E Park Ave
Suite 300
Long Beach, NY 11561-3595

Mailing address

2775 Island Channel Rd
Seaford, NY 11783-3324
Phone (516) 889-0080

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
I20051128000499 NY Practitioner - Clinical Social Worker 9537189204 Practice locations: Long Beach, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26 E Park Ave
Suite 300
Long Beach, NY 11561-3301
Phone (516) 889-0080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO48618-1NYMDClinical Social Worker
048618NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053435107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 ISLAND CHANNEL RD",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117833324",
            "telephone_number": "516-889-0080",
            "fax_number": "516-785-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 E PARK AVE",
            "address_2": "SUITE 300",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613595",
            "telephone_number": "516-889-0080",
            "fax_number": "516-785-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVEY",
        "first_name": "COLLEEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO48618-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.