Individual provider Active NPI

Sydney Laura Pollock-Tobert, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1376912261
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088547 Issued in NY
Practice address
27 W 96TH St Ste Aoffice2
New York, NY 10025-6607
Phone
(201) 417-5597
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 097718 NY
Clinical Social Worker 1041C0700X 088547 NY Primary

Addresses

Primary practice location

27 W 96TH St Ste Aoffice2
New York, NY 10025-6607

Mailing address

295 Central Park W Ofc 2
New York, NY 10024-3021
Phone (201) 417-5597

Other practice location 1

245 W 29th St Rm 405
New York, NY 10001-5437
Phone (201) 417-5597

Other practice location 2

1301 5th Ave
1st Floord
New York, NY 10029-3119
Phone (212) 426-3400

Other practice location 3

244 Madison Ave # 1435
New York, NY 10016-2817
Phone (347) 979-7105

Other practice location 4

208 Washington Park Apt 1B
Brooklyn, NY 11205-4023
Phone (201) 417-5597

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
I20190827002116 NY Order and Referring Only - Clinical Social Worker 8325376452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097718NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1376912261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 CENTRAL PARK W OFC 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243021",
            "telephone_number": "201-417-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 W 96TH ST STE AOFFICE2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256607",
            "telephone_number": "201-417-5597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 W 29th St Rm 405",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100015437",
            "country_code": "US",
            "telephone_number": "201-417-5597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 5th Ave",
            "address_2": "1st Floord",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100293119",
            "country_code": "US",
            "telephone_number": "212-426-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "244 Madison Ave # 1435",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100162817",
            "country_code": "US",
            "telephone_number": "347-979-7105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 Washington Park Apt 1B",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112054023",
            "country_code": "US",
            "telephone_number": "201-417-5597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLOCK-TOBERT",
        "first_name": "SYDNEY",
        "middle_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097718",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.