Individual provider Active NPI

Dana Kane-Glickman, CSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1093875817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-029550-1 Issued in NY
Practice address
22 McCulloch Dr
Dix Hills, NY 11746-8304
Phone
(516) 702-0957
Fax
(631) 462-9198
NPI assigned
Dec 11, 2006
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R-029550-1 NY Primary

Addresses

Primary practice location

22 McCulloch Dr
Dix Hills, NY 11746-8304

Mailing address

22 McCulloch Dr
Dix Hills, NY 11746-8304
Phone (516) 702-0957

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
I20070209000504 NY Practitioner - Clinical Social Worker 9739181389 Practice locations: Dix Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 McCulloch Dr
Dix Hills, NY 11746-8304
Phone (516) 702-0957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-029550-1NYMDClinical Social Worker
029550NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Juliana Kanji Psychiatric Services, PC 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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093875817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MCCULLOCH DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468304",
            "telephone_number": "516-702-0957",
            "fax_number": "631-462-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MCCULLOCH DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468304",
            "telephone_number": "516-702-0957",
            "fax_number": "631-462-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE-GLICKMAN",
        "first_name": "DANA",
        "name_prefix": "Ms.",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-029550-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.