Individual provider Active NPI

Carly Schram

  • Clinical Social Worker
  • Lindenhurst, NY
National Provider Identifier
1396523494
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
72-P124817-01 Issued in NY
Practice address
145 Sunrise Hwy
Lindenhurst, NY 11757-2500
Phone
(516) 254-9201
NPI assigned
Sep 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 72-P124817-01 NY Primary

Addresses

Primary practice location

145 Sunrise Hwy
Lindenhurst, NY 11757-2500

Mailing address

300 West Windsor Park Way
Oceanside, NY 11572
Phone (516) 978-6094

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
72-P124817-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1396523494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST WINDSOR PARK WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "11572",
            "telephone_number": "516-978-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SUNRISE HWY",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572500",
            "telephone_number": "516-254-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAM",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "72-P124817-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.