Active NPI
Pamela Mira Lotenberg, PHD, LCSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1205923752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R045848
- Practice address
- 9435 Ridge Blvd
Brooklyn, NY 11209-6750 - Phone
- (718) 238-6444
- Fax
- (718) 238-5165
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R045848 | NY | Primary |
Addresses
Primary practice location
9435 Ridge Blvd
Brooklyn, NY 11209-6750
Mailing address
216 W 89TH St
#5A
New York, NY 10024-1822
Phone (917) 865-0688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R045848 | Other | NY | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2014 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R045848 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jewish Board for Family and Children Services | Past | Accepting new patients | |
| Jewish Board of Family and Children'S Services, Inc. | Clinical | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1366685430
-
- Addiction (Substance Use Disorder) Counselor
- Brooklyn, NY
- NPI 1760173579
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205923752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 W 89TH ST",
"address_2": "#5A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241822",
"telephone_number": "917-865-0688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9435 RIDGE BLVD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112096750",
"telephone_number": "718-238-6444",
"fax_number": "718-238-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOTENBERG",
"first_name": "PAMELA",
"middle_name": "MIRA",
"credential": "PHD, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R045848",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "R045848",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.