Individual provider Active NPI

Gabrielle Teller, LMSW

  • Clinical Social Worker
  • Far Rockaway, NY
National Provider Identifier
1316100399
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080887-1 Issued in NY
Practice address
156 Beach 9TH St
Suite C
Far Rockaway, NY 11691-5636
Phone
(347) 695-9700
Fax
(347) 697-9701
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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 080887-1 NY Primary

Addresses

Primary practice location

156 Beach 9TH St
Suite C
Far Rockaway, NY 11691-5636

Mailing address

520 Jarvis Ave
Far Rockaway, NY 11691-5426
Phone (917) 291-3490

Other names 1

  • Miss Gabrielle Taubenblat Former name

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
I20210624002798 NY Practitioner - Clinical Social Worker 3577964733 Practice locations: Woodmere, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

22 Edward Ave
Woodmere, NY 11598-2847
Phone (917) 291-3490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080887-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohel Children'S Home and Family Services, Inc. Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1316100399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JARVIS AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915426",
            "telephone_number": "917-291-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 BEACH 9TH ST",
            "address_2": "SUITE C",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915636",
            "telephone_number": "347-695-9700",
            "fax_number": "347-697-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLER",
        "first_name": "GABRIELLE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080887-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "TAUBENBLAT",
            "prefix": "MISS",
            "credential": "STUDENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.