Individual provider Active NPI

Lloyd Fider, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1396151528
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081994 Issued in NY
Practice address
112 W 34TH St FL 17
New York, NY 10120
Phone
(516) 660-0025
Fax
(718) 744-9755
NPI assigned
Jul 9, 2014
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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 081994 NY Primary

Addresses

Primary practice location

112 W 34TH St FL 17
New York, NY 10120

Mailing address

112 W 34TH St FL 17
New York, NY 10120-0001
Phone (516) 660-0025

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Harbor Psychotherapy LCSW, PLLC Clinical PastSince Feb 16, 2020 Accepting new patients

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1396151528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W 34TH ST FL 17",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101200001",
            "telephone_number": "516-660-0025",
            "fax_number": "718-744-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W 34TH ST FL 17",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10120",
            "telephone_number": "516-660-0025",
            "fax_number": "718-744-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDER",
        "first_name": "LLOYD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081994",
            "primary": true
        }
    ],
    "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 Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.