Individual provider Active NPI

David Warren Goldfarb, RLCSW

  • School Social Worker
  • Brentwood, NY
National Provider Identifier
1396014957
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
038477 Issued in NY
Practice address
2 6TH Ave
Brentwood, NY 11717-6110
Phone
(631) 434-2561
Fax
(631) 434-2319
NPI assigned
Dec 27, 2011
Last updated
Dec 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 038477 NY Primary

Addresses

Primary practice location

2 6TH Ave
Brentwood, NY 11717-6110

Mailing address

2 6TH Ave
Brentwood, NY 11717-6110
Phone (631) 434-2561

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
I20240507003861 NY Practitioner - Clinical Social Worker 1951742097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Living Behavioral Health LCSW PLLCGroup PAC ID 9931482247, 17 clinicians

Practice addresses (Care Compare)

1065 Smithtown Ave
Bohemia, NY 11716-3800
Phone (631) 567-3113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1065 Smithtown Ave
Bohemia, NY 11716
Phone (631) 388-7616

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": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1396014957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 6TH AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176110",
            "telephone_number": "631-434-2561",
            "fax_number": "631-434-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 6TH AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176110",
            "telephone_number": "631-434-2561",
            "fax_number": "631-434-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "DAVID",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "RLCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "038477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.