Individual provider Active NPI

Rachel Hersch, LCSW

  • Clinical Social Worker
  • Syosset, NY
National Provider Identifier
1215097308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040076-1 Issued in NY
Practice address
314 Jackson Ave
Syosset, NY 11791-4124
Phone
(516) 379-0504
Fax
(516) 364-0738
NPI assigned
Dec 11, 2006
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 R040076-1 NY Primary

Addresses

Primary practice location

314 Jackson Ave
Syosset, NY 11791-4124

Mailing address

314 Jackson Ave
Syosset, NY 11791-4124
Phone (516) 379-0504

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
I20040804001925 NY Practitioner - Clinical Social Worker 5597736264 Practice locations: Syosset, 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

314 Jackson Ave
Syosset, NY 11791-4124
Phone (516) 379-0504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040076-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215097308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 JACKSON AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914124",
            "telephone_number": "516-379-0504",
            "fax_number": "516-364-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 JACKSON AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914124",
            "telephone_number": "516-379-0504",
            "fax_number": "516-364-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSCH",
        "first_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040076-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.