Individual provider Active NPI

Judith A Guberman, ACSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1265554976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R030097-1 Issued in NY
Practice address
350 Central Park W
Suite 1B
New York, NY 10025-6547
Phone
(212) 866-2881
Fax
(212) 866-2881
NPI assigned
Apr 4, 2007
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 R030097-1 NY Primary

Addresses

Primary practice location

350 Central Park W
Suite 1B
New York, NY 10025-6547

Mailing address

514 W 110TH St
Apt 9a
New York, NY 10025-2080
Phone (212) 866-2881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R030097-1NYMDClinical Social Worker
030097NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265554976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W 110TH ST",
            "address_2": "APT 9A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252080",
            "telephone_number": "212-866-2881",
            "fax_number": "212-866-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CENTRAL PARK W",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256547",
            "telephone_number": "212-866-2881",
            "fax_number": "212-866-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBERMAN",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R030097-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.