Individual provider Active NPI

Malaika Gutman-Gates

  • Clinical Social Worker
  • Pleasantville, NY
National Provider Identifier
1265016935
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076521 Issued in NY
Practice address
1075 Broadway
Pleasantville, NY 10570-2346
Phone
(914) 281-4512
NPI assigned
May 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 076521 NY Primary

Addresses

Primary practice location

1075 Broadway
Pleasantville, NY 10570-2346

Mailing address

1075 Broadway
Pleasantville, NY 10570-2346
Phone (914) 281-4512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 3, 2021 through Jun 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
076521NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1265016935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BROADWAY",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702346",
            "telephone_number": "914-281-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BROADWAY",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702346",
            "telephone_number": "914-281-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN-GATES",
        "first_name": "MALAIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NY

Sources for this page

Verify at the official NPI Registry.