Individual provider Active NPI

Rachel Susan Stiene, L.C.S.W.

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1124037999
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
054452 Issued in NY
Practice address
10504 Sutphin Blvd
Jamaica, NY 11435-5022
Phone
(718) 681-8700
Fax
(718) 943-6788
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 054452 NY Primary

Addresses

Primary practice location

10504 Sutphin Blvd
Jamaica, NY 11435-5022

Mailing address

9131 Queens Blvd Ste 222
Elmhurst, NY 11373-5511
Phone (718) 896-3400

Other identifiers 1

IdentifierTypeStateIssuer
01420795MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center CurrentSince Aug 15, 2021 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1124037999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 QUEENS BLVD STE 222",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735511",
            "telephone_number": "718-896-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10504 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355022",
            "telephone_number": "718-681-8700",
            "fax_number": "718-943-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIENE",
        "first_name": "RACHEL",
        "middle_name": "SUSAN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "054452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.