Individual provider Active NPI

Mohanne Charles, LCSW

  • Clinical Social Worker
  • Bayside, NY
National Provider Identifier
1194281691
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087781 Issued in NY
Practice address
21337 39TH Ave Ste 308
Bayside, NY 11361-2071
Phone
(917) 599-3533
Fax
(718) 691-4968
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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 087781 NY Primary

Addresses

Primary practice location

21337 39TH Ave Ste 308
Bayside, NY 11361-2071

Mailing address

21337 39TH Ave Ste 308
Bayside, NY 11361-2071
Phone (917) 599-3533

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
Mohanne LCSW PLLC Clinical CurrentSince Jan 4, 2026 Accepting new patients
Cityblock Medical Practice, P.a. PastSince Jan 1, 2022 Accepting new patients

Locations

21337 39th Ave
Bayside, NY 11361
Phone (917) 599-3533

Organizations & group practices 2

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": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1194281691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21337 39TH AVE STE 308",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612071",
            "telephone_number": "917-599-3533",
            "fax_number": "718-691-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21337 39TH AVE STE 308",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612071",
            "telephone_number": "917-599-3533",
            "fax_number": "718-691-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MOHANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.