Individual provider Active NPI

Kashima Thoms-Clark, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1053600536
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070351 Issued in NY
Practice address
1850 Amsterdam Ave BSMT
New York, NY 10031-1714
Phone
(644) 773-7012
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 070351 NY Primary

Addresses

Primary practice location

1850 Amsterdam Ave BSMT
New York, NY 10031-1714

Mailing address

25 Woodrow Pkwy
West Babylon, NY 11704-7314
Phone (347) 879-1652

Other names 1

  • Kashima Thoms Former name

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
I20110516000686 NY Practitioner - Clinical Social Worker 6608052287 Practice locations: Bronx, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

981 Morris Park Ave
Apt 8
Bronx, NY 10462-3787
Phone (646) 773-7012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients
New York Psychotherapy and Counseling Center PastSince Dec 19, 2009 Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1053600536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODROW PKWY",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047314",
            "telephone_number": "347-879-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 AMSTERDAM AVE BSMT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100311714",
            "telephone_number": "644-773-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMS-CLARK",
        "first_name": "KASHIMA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-05-20",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASHIMA",
            "last_name": "THOMS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.