Individual provider Active NPI

Dorothy Paulette Fried, LCSW

  • Clinical Social Worker
  • Floral Park, NY
National Provider Identifier
1073598959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0300491 Issued in NY
Practice address
174 Jericho Tpke
Floral Park, NY 11001-2024
Phone
(516) 775-4258
Fax
(516) 671-5437
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

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 0300491 NY Primary

Addresses

Primary practice location

174 Jericho Tpke
Floral Park, NY 11001-2024

Mailing address

294 Prospect Ave
Sea Cliff, NY 11579-1026
Phone (516) 676-1599

Other names 1

  • Mrs. Dorothy Paulette Goldstein Former name

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

LicenseStateTypeSpecialty
0300491NYMDClinical Social Worker
030049NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073598959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 PROSPECT AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791026",
            "telephone_number": "516-676-1599",
            "fax_number": "516-671-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012024",
            "telephone_number": "516-775-4258",
            "fax_number": "516-671-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "DOROTHY",
        "middle_name": "PAULETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0300491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY",
            "last_name": "GOLDSTEIN",
            "middle_name": "PAULETTE",
            "prefix": "MRS.",
            "credential": "LSCW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.