Individual provider Active NPI

Peter Ian Chernack, MSW, LCSW-R, DSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1063177814
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
025966 Issued in NY
Practice address
226 E 52ND St
New York, NY 10022-6201
Phone
(212) 712-8800
NPI assigned
Nov 6, 2021
Last updated
Nov 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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 025966 NY Primary

Addresses

Primary practice location

226 E 52ND St
New York, NY 10022-6201

Mailing address

4550 Pearson St Apt 7K
Long Island City, NY 11101-4367
Phone (516) 241-1297

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
025966NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636156800000",
    "number": "1063177814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 PEARSON ST APT 7K",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014367",
            "telephone_number": "516-241-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E 52ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226201",
            "telephone_number": "212-712-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNACK",
        "first_name": "PETER",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MSW, LCSW-R, DSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-06",
        "last_updated": "2021-11-06",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "025966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.