Individual provider Active NPI

Terry Robin Williams, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1073751434
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0638894 Issued in NY
Practice address
406 E 176TH St
Bronx, NY 10457-6003
Phone
(718) 901-6862
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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 0638894 NY Primary

Addresses

Primary practice location

406 E 176TH St
Bronx, NY 10457-6003

Mailing address

131 John St
Englewood, NJ 07631-2229
Phone (201) 569-6132

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
I20170227000078 NY Practitioner - Clinical Social Worker 1658655311 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0638894NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Jan 15, 2021 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Jan 15, 2021 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • 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": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1073751434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 JOHN ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312229",
            "telephone_number": "201-569-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E 176TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104576003",
            "telephone_number": "718-901-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TERRY",
        "middle_name": "ROBIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0638894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.