Individual provider Active NPI

Gail Williams Copeland, LCSW

  • Clinical Social Worker
  • Rego Park, NY
National Provider Identifier
1336212018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074014 Issued in NY
Practice address
9729 64TH Rd
Rego Park, NY 11374-2240
Phone
(718) 896-3400
Fax
(718) 459-5621
NPI assigned
Nov 17, 2006
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 074014 NY Primary

Addresses

Primary practice location

9729 64TH Rd
Rego Park, NY 11374-2240

Mailing address

13211 133Rd Ave
South Ozone Park, NY 11420-3812
Phone (718) 322-8188

Other identifiers 1

IdentifierTypeStateIssuer
00244019MedicaidNY

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
I20050308000491 NY Practitioner - Clinical Social Worker 7214981778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Consultation Center IncGroup PAC ID 8729068622, 19 clinicians

Practice addresses (Care Compare)

9131 Queens Blvd
Suite 222
Elmhurst, NY 11373-5511
Phone (718) 896-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074014NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. Clinical CurrentSince Sep 2, 2003 Accepting new patients
Long Island Consultation Center CurrentSince Aug 15, 2021 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 2

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336212018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13211 133RD AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203812",
            "telephone_number": "718-322-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742240",
            "telephone_number": "718-896-3400",
            "fax_number": "718-459-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "GAIL",
        "middle_name": "WILLIAMS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.