Individual provider Active NPI

Cindy Roseto, LCSW

  • Clinical Social Worker
  • Southampton, NY
National Provider Identifier
1093913923
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079422 Issued in NY
Practice address
46 Main St
2ND Floor
Southampton, NY 11968-4864
Phone
(415) 299-0040
Fax
(415) 299-0040
NPI assigned
Jul 3, 2007
Last updated
Oct 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 44SL05388200 NJ
Clinical Social Worker 1041C0700X 079422 NY Primary

Addresses

Primary practice location

46 Main St
2ND Floor
Southampton, NY 11968-4864

Mailing address

333 W 55TH St
2C
New York, NY 10019-4515
Phone (415) 299-0040

Other identifiers 3

IdentifierTypeStateIssuer
079422OtherNYNY STATE LICENSE
44SC05376000OtherNJSTATE LICENSE
44SL05388200OtherNJSTATE LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SL05388200NJMDPsychologist
079422NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1093913923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 55TH ST",
            "address_2": "2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100194515",
            "telephone_number": "415-299-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 MAIN ST",
            "address_2": "2ND FLOOR",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684864",
            "telephone_number": "415-299-0040",
            "fax_number": "415-299-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSETO",
        "first_name": "CINDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "44SL05388200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "079422",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "44SC05376000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "44SL05388200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.