Individual provider Active NPI

Stephanie Mullen, LMSW

  • Clinical Social Worker
  • Ny, NY
National Provider Identifier
1346993557
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110199 Issued in NY
Practice address
57 West 57TH Street
Suite 1101
Ny, NY 10019
Phone
(203) 722-1434
NPI assigned
Jan 28, 2022
Last updated
Jan 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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 110199 NY Primary

Addresses

Primary practice location

57 West 57TH Street
Suite 1101
Ny, NY 10019

Mailing address

57 W 57TH St Ste 1101
New York, NY 10019-2814

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
I20250514002385 NY Practitioner - Clinical Social Worker 9830617703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Merrick Rd
Suite 510
Rockville Centre, NY 11570-4804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110199NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
East Rockaway Neuropsychology, PC CurrentSince May 9, 2025 Accepting new patients

Locations

100 Merrick Rd
Ofc 510E
Rockville Ctr, NY 11570

100 Merrick Rd
Ste 510
Rockville Ctr, NY 11570
Phone (516) 341-6215

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1346993557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 WEST 57TH STREET",
            "address_2": "SUITE 1101",
            "city": "NY",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "203-722-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "110199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ny, NY

Sources for this page

Verify at the official NPI Registry.