Individual provider Active NPI

Andrea P Blumenthal, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1205086741
Registry record updated Sep 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR058849-1 Issued in NY
Practice address
19 W 34TH St PH
New York, NY 10001-3006
Phone
(646) 351-9444
NPI assigned
Sep 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2008

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 PR058849-1 NY Primary

Addresses

Primary practice location

19 W 34TH St PH
New York, NY 10001-3006

Mailing address

145 W 67TH St Apt 22K
New York, NY 10023-5935
Phone (646) 351-9444

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
I20150618002964 NY Order and Referring Only - Clinical Social Worker 7517278435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR058849-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221868800000",
    "number": "1205086741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 67TH ST APT 22K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235935",
            "telephone_number": "646-351-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 34TH ST PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013006",
            "telephone_number": "646-351-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENTHAL",
        "first_name": "ANDREA",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-20",
        "last_updated": "2008-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR058849-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.