Active NPI
Gregory D Carson, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1336364199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070645
- Practice address
- 156 5TH Ave Ste 725
New York, NY 10010-7772 - Phone
- (917) 796-2760
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070645 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 44SC05257300 | NJ |
Addresses
Primary practice location
156 5TH Ave Ste 725
New York, NY 10010-7772
Mailing address
16 Carolin Rd
Upper Montclair, NJ 07043-2224
Phone (917) 796-2760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05257300 | NJ | MD | Clinical Social Worker |
| 070645 | NY | MD | Clinical Social Worker |
| 063357 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336364199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CAROLIN RD",
"city": "UPPER MONTCLAIR",
"state": "NJ",
"postal_code": "070432224",
"telephone_number": "917-796-2760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 5TH AVE STE 725",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100107772",
"telephone_number": "917-796-2760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON",
"first_name": "GREGORY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070645",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05257300",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.