Individual provider Active NPI

Robin Ann Bezark, LCSW

  • Clinical Social Worker
  • Katonah, NY
National Provider Identifier
1174763585
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR024053 Issued in NY
Practice address
103 Lily Pond LN
Katonah, NY 10536-1804
Phone
(914) 232-8326
Fax
(914) 232-8166
NPI assigned
Feb 25, 2009
Sex
Female
Sole proprietor
Yes

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
PR024053NYMDClinical Social Worker

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR024053 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

103 Lily Pond LN
Katonah, NY 10536-1804

Mailing address

103 Lily Pond LN
Katonah, NY 10536-1804
Phone (914) 232-8326

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 25, 2009.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1174763585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 LILY POND LN",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105361804",
            "telephone_number": "914-232-8326",
            "fax_number": "914-232-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 LILY POND LN",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105361804",
            "telephone_number": "914-232-8326",
            "fax_number": "914-232-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZARK",
        "first_name": "ROBIN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR024053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katonah, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.