Individual provider Active NPI

Ingrid Gemma Rousseau, LMSW

  • Clinical Social Worker
  • West Hempstead, NY
National Provider Identifier
1124194550
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069648 Issued in NY
Practice address
508 Maryann LN
West Hempstead, NY 11552-4017
Phone
(516) 437-0152
Fax
(516) 437-0152
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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 069648 NY Primary

Addresses

Primary practice location

508 Maryann LN
West Hempstead, NY 11552-4017

Mailing address

508 Maryann LN
West Hempstead, NY 11552-4017
Phone (516) 437-0152

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
069648NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1124194550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 MARYANN LN",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115524017",
            "telephone_number": "516-437-0152",
            "fax_number": "516-437-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 MARYANN LN",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115524017",
            "telephone_number": "516-437-0152",
            "fax_number": "516-437-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "INGRID",
        "middle_name": "GEMMA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hempstead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.