Individual provider Active NPI

Lea M Boriskin, LCSW

  • Clinical Social Worker
  • South Ozone Park, NY
National Provider Identifier
1154571396
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078617 Issued in NY
Practice address
10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone
(718) 845-2620
Fax
(718) 845-9380
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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 078617 NY Primary

Addresses

Primary practice location

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034

Mailing address

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone (718) 845-2620

Other identifiers 1

IdentifierTypeStateIssuer
00078617MedicaidNY

Other names 1

  • Lea M Greenspan Former name

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
I20120229000125 NY Practitioner - Clinical Social Worker 9739347311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

775 Brooklyn Ave
Suite 108
North Baldwin, NY 11510-2948
Phone (917) 826-1644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078617NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Counseling LCSW P.C. Clinical CurrentSince Jan 3, 2017 Accepting new patients
New Horizon Counseling Center Inc CurrentSince Dec 5, 2011 Accepting new patients
Long Island Psychological Services PLLC CurrentSince Jan 1, 2015 Accepting new patients

Locations

775 Brooklyn Ave
Ste 108
North Baldwin, NY 11510
Phone (917) 826-1644

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

Organizations & group practices 3

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1154571396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10819 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201034",
            "telephone_number": "718-845-2620",
            "fax_number": "718-845-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10819 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201034",
            "telephone_number": "718-845-2620",
            "fax_number": "718-845-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORISKIN",
        "first_name": "LEA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00078617",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEA",
            "last_name": "GREENSPAN",
            "middle_name": "M",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.