Otto Michael Berk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R-042031 Issued in NY

Practice address

6762 Burns St
Forest Hills, NY 11375-3537

Phone

(718) 544-5522

Fax

(718) 544-2345

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1225033525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 BURNS ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753537",
            "telephone_number": "718-544-5522",
            "fax_number": "718-544-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6762 BURNS ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753537",
            "telephone_number": "718-544-5522",
            "fax_number": "718-544-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERK",
        "first_name": "OTTO",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-042031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP NY STATE",
            "identifier": "182780P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2445244",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02480211",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MULTIPLAN",
            "identifier": "2826599000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "558471000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH",
            "identifier": "1050730",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSHIP EMPIRE PLAN",
            "identifier": "518370",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "N797C1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10208395",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "518370",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7527622",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "248062964",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET MHN",
            "identifier": "307450",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3462946",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Bergenbaum
• Alexander Berger, CASAC
• Chani Berger, R - P.A., CERTIFIED
• Natalya Beria
• Revaz Beridze, DDS
• Charlene Sue Berkman, DMD
• Jordana Berkowitz
• Mitchell Berkowitz, P.T.
• Tiffany Berlangieri
• Rebecca Erin Berlin, OTR/L

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.