Individual provider Active NPI

Beth Lazarus, LCSW

  • Clinical Social Worker
  • Bayside, NY
National Provider Identifier
1205048006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0211921 Issued in NY
Practice address
21704 Northern Blvd
Suite 29
Bayside, NY 11361-3500
Phone
(718) 423-7371
NPI assigned
May 4, 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 R0211921 NY Primary

Addresses

Primary practice location

21704 Northern Blvd
Suite 29
Bayside, NY 11361-3500

Mailing address

217-04 Northern Blvd
Suite 29
Bayside, NY 11361
Phone (718) 423-7371

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
I20090214000001 NY Practitioner - Clinical Social Worker 9830254416 Practice locations: Bayside, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

217 -04 Northern Blvd
Bayside, NY 11361-3500
Phone (516) 369-7073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0211921NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205048006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217-04 NORTHERN BLVD",
            "address_2": "SUITE 29",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "718-423-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21704 NORTHERN BLVD",
            "address_2": "SUITE 29",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613500",
            "telephone_number": "718-423-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0211921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.