Park South Psychotherapy, LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PARK SOUTH PSYCHOTHERAPY, LCSW, LLC

Practice address

295 Madison Ave FL 12
New York, NY 10017-6379

Phone

(212) 292-0960

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Melissa Gerson, LCSWNPI 1598838237

Title

Owner

Phone

(646) 245-2021

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa R. Gerson, LCSW

  • Clinical Social Worker
  • New York, NY
  • NPI 1598838237
  NPD Authorized official

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1306487376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176379",
            "telephone_number": "212-292-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176379",
            "telephone_number": "212-292-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SOUTH PSYCHOTHERAPY, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "GERSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-245-2021",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Sleep Vip & Wellness LLC
• Park Smiles Dental PLLC Dba Park Smiles Nyc
• Park Smiles Dental PLLC Dba Park Smiles West
• Park South Physical Therapy Group PC
• Park South Podiatry LLC
• Park Square Medical PC
• Park Therapy LCSW, PLLC
• Park Urologic, PC
• Park View Dental P.C.
• Park West Dental PC

• Clinical Social Worker in New York, NY
• Providers in New York, 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 Jan 17, 2022; 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.