Individual provider Active NPI

Mandy Hirschheimer-Breslow, MS ED, LCSW

  • Clinical Social Worker
  • Bethpage, NY
National Provider Identifier
1326297862
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
060978 Issued in NY
Practice address
90 Elizabeth Dr
Bethpage, NY 11714-6432
Phone
(516) 579-3531
NPI assigned
Sep 9, 2008
Last updated
Jun 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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 060978 NY Primary

Addresses

Primary practice location

90 Elizabeth Dr
Bethpage, NY 11714-6432

Mailing address

90 Elizabeth Dr
Bethpage, NY 11714-6432
Phone (516) 579-3531

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
I20190219001286 NY Practitioner - Clinical Social Worker 5092033548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brooklyn Psychotherapy Services LCSW PLLCGroup PAC ID 1153628490, 6 clinicians

Practice addresses (Care Compare)

2829 Ocean Pkwy
Suite 2
Brooklyn, NY 11235-7859
Phone (917) 933-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Psychotherapy Services LCSW PLLC Clinical CurrentSince Dec 30, 2018 Accepting new patients

Locations

2829 Ocean Pkwy
Ste 2
Brooklyn, NY 11235
Phone (718) 891-6500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1326297862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ELIZABETH DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117146432",
            "telephone_number": "516-579-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ELIZABETH DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117146432",
            "telephone_number": "516-579-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCHHEIMER-BRESLOW",
        "first_name": "MANDY",
        "name_prefix": "Mrs.",
        "credential": "MS ED, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "060978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.