Individual provider Active NPI

Grace Berman, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1417440801
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088940 Issued in NY
Practice address
57 W 57TH St Ste 507
New York, NY 10019-2826
Phone
(212) 337-0600
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 010184 CT
Clinical Social Worker 1041C0700X 088940 NY Primary

Addresses

Primary practice location

57 W 57TH St Ste 507
New York, NY 10019-2826

Mailing address

57 W 57TH St Ste 507
New York, NY 10019-2826
Phone (212) 337-0600

Other practice location 1

40 Temple St Ste 7C
New Haven, CT 06510-2715
Phone (203) 737-5892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 13, 2024 through Nov 13, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
088940NYMDSocial Worker
010184CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1417440801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 507",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192826",
            "telephone_number": "212-337-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 507",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192826",
            "telephone_number": "212-337-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Temple St Ste 7C",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102715",
            "country_code": "US",
            "telephone_number": "203-737-5892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010184",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.