Individual provider Active NPI

Rosalie Harris, L.C.S.W.

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1144359589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
062509 Issued in NY
Practice address
67 Bayview Ave
Great Neck, NY 11021-1731
Phone
(516) 466-3563
Fax
(516) 466-2781
NPI assigned
Mar 2, 2007
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 062509 NY Primary

Addresses

Primary practice location

67 Bayview Ave
Great Neck, NY 11021-1731

Mailing address

67 Bayview Ave
Great Neck, NY 11021-1731
Phone (516) 466-3563

Other identifiers 1

IdentifierTypeStateIssuer
062509OtherNYNEW YORK STATE 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
062509NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144359589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 BAYVIEW AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211731",
            "telephone_number": "516-466-3563",
            "fax_number": "516-466-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BAYVIEW AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211731",
            "telephone_number": "516-466-3563",
            "fax_number": "516-466-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROSALIE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "062509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "062509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.