Individual provider Active NPI

Melissa F Coren, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1205821006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040195-1 Issued in NY
Practice address
884 W End Ave
New York, NY 10025-3514
Phone
(212) 663-8339
Fax
(212) 663-8733
NPI assigned
Sep 18, 2005
Sex
Female
Sole proprietor
No

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 R040195-1 NY Primary

Addresses

Primary practice location

884 W End Ave
New York, NY 10025-3514

Mailing address

884 W End Ave
New York, NY 10025-3514
Phone (212) 663-8339

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
I20101203000655 NY Practitioner - Clinical Social Worker 7214124296 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

884 W End Ave
New York, NY 10025-3514
Phone (212) 663-8339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040195-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1127001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205821006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253514",
            "telephone_number": "212-663-8339",
            "fax_number": "212-663-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 W END AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253514",
            "telephone_number": "212-663-8339",
            "fax_number": "212-663-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREN",
        "first_name": "MELISSA",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040195-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.