Individual provider Active NPI

Lori Rose Grant, LCSW

  • Clinical Social Worker
  • Long Beach, NY
National Provider Identifier
1275749459
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R022705-1 Issued in NY
Practice address
242 E Olive Street
Long Beach, NY 11561
Phone
(516) 889-4403
Fax
(516) 889-4403
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

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 R022705-1 NY Primary

Addresses

Primary practice location

242 E Olive Street
Long Beach, NY 11561

Mailing address

242 E Olive Street
Long Beach, NY 11561
Phone (516) 889-4403

Other identifiers 2

IdentifierTypeStateIssuer
146500OtherNYVALUE OPTIONS
0000194OtherNYGHI

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
I20180821001290 NY Practitioner - Clinical Social Worker 7214286459 Practice locations: Long Beach, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

242 E Olive St
Long Beach, NY 11561-3525
Phone (516) 889-4403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R022705-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275749459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 E OLIVE STREET",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-889-4403",
            "fax_number": "516-889-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 E OLIVE STREET",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-889-4403",
            "fax_number": "516-889-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "LORI",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R022705-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "146500",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0000194",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.