Individual provider Active NPI

Swgotretse Racey Glover, LCSW-R

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1093834731
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071976-1R Issued in NY
Practice address
1360 Fulton St
Suite 502
Brooklyn, NY 11216-2636
Phone
(718) 636-5279
Fax
(718) 636-5517
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 104100000X NY
Family Nurse Practitioner 363LF0000X F342707-01 NY
Registered Nurse 163W00000X 664571-01 NY
Clinical Social Worker 1041C0700X 071976-1R NY Primary

Addresses

Primary practice location

1360 Fulton St
Suite 502
Brooklyn, NY 11216-2636

Mailing address

60 E 93Rd St
Apt.# D311
Brooklyn, NY 11212-2353
Phone (718) 636-5279

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
071976-1RNYMDClinical Social Worker
664571-01NYMDRegistered Nurse
104100000XNYMDSpecialist
071976NYMDPharmacist
F342707-01NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1093834731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E 93RD ST",
            "address_2": "APT.# D311",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112122353",
            "telephone_number": "718-636-5279",
            "fax_number": "718-636-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 FULTON ST",
            "address_2": "SUITE 502",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162636",
            "telephone_number": "718-636-5279",
            "fax_number": "718-636-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "SWGOTRETSE",
        "middle_name": "RACEY",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NY",
            "license": "104100000X",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342707-01",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "664571-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071976-1R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.