Individual provider Active NPI

Marc Grossman, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1073676219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R043196 Issued in NY
Practice address
160 W End Ave
Suite 1N
New York, NY 10023-5601
Phone
(212) 362-1086
Fax
(212) 877-9204
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R043196 NY Primary
Clinical Social Worker 1041C0700X 44SC04701000 NJ

Addresses

Primary practice location

160 W End Ave
Suite 1N
New York, NY 10023-5601

Mailing address

160 W End Ave
Suite 1N
New York, NY 10023-5601
Phone (212) 362-1086

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
I20040728001602 NY Practitioner - Clinical Social Worker 6406826262 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

160 W End Ave
Apt 1N
New York, NY 10023-5602
Phone 21236210861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04701000NJMDClinical Social Worker
R043196NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New York Counseling and CSW Service, P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073676219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W END AVE",
            "address_2": "SUITE 1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235601",
            "telephone_number": "212-362-1086",
            "fax_number": "212-877-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W END AVE",
            "address_2": "SUITE 1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235601",
            "telephone_number": "212-362-1086",
            "fax_number": "212-877-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MARC",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043196",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04701000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.