Individual provider Active NPI

Jeffrey R Lawrence, MSW

  • Clinical Social Worker
  • Woodmere, NY
National Provider Identifier
1114913720
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR007430-1 Issued in NY
Practice address
949 Central Ave
Ste 200
Woodmere, NY 11598-1204
Phone
(516) 374-1360
Fax
(516) 536-0313
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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 PR007430-1 NY Primary

Addresses

Primary practice location

949 Central Ave
Ste 200
Woodmere, NY 11598-1204

Mailing address

949 Central Ave
Ste 200
Woodmere, NY 11598-1204
Phone (516) 374-1360

Other identifiers 2

IdentifierTypeStateIssuer
R007430OtherNYHIP PROVIDER #
0054754OtherNYGHI PROVIDER#

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
I20110413000038 NY Practitioner - Clinical Social Worker 5799969960 Practice locations: Woodmere, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

949 Central Ave
Suite 200
Woodmere, NY 11598-1204
Phone (516) 374-1360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR007430-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1114913720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 CENTRAL AVE",
            "address_2": "STE 200",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981204",
            "telephone_number": "516-374-1360",
            "fax_number": "516-536-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 CENTRAL AVE",
            "address_2": "STE 200",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981204",
            "telephone_number": "516-374-1360",
            "fax_number": "516-536-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR007430-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP PROVIDER #",
            "identifier": "R007430",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER#",
            "identifier": "0054754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

Verify at the official NPI Registry.