Individual provider Active NPI

Garret Zeidner, LCSW

  • Clinical Social Worker
  • Stony Brook, NY
National Provider Identifier
1396261053
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092800 Issued in NY
Practice address
215 Hallock Rd Ste 1a
Stony Brook, NY 11790-3079
Phone
(917) 217-8440
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 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 092800 NY Primary

Addresses

Primary practice location

215 Hallock Rd Ste 1a
Stony Brook, NY 11790-3079

Mailing address

215 Hallock Rd Ste 1a
Stony Brook, NY 11790-3079
Phone (917) 217-8440

Other names 1

  • Garret Zeidner-Rodriguez Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
092800NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Rockville Centre PastSince Oct 1, 2019 Accepting new patients
Catholic Charities of the Diocese of Rockville Centre PastSince Oct 1, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1396261053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 1A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903079",
            "telephone_number": "917-217-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HALLOCK RD STE 1A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903079",
            "telephone_number": "917-217-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEIDNER",
        "first_name": "GARRET",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARRET",
            "last_name": "ZEIDNER-RODRIGUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.