Individual provider Active NPI

Kenneth G Lent, LCSW

  • Clinical Social Worker
  • Port Jefferson Station, NY
National Provider Identifier
1437201498
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
048202-1 Issued in NY
Practice address
6 Roosevelt Ave Ste 2
Port Jefferson Station, NY 11776-3364
Phone
(631) 474-1533
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 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 048202-1 NY Primary

Addresses

Primary practice location

6 Roosevelt Ave Ste 2
Port Jefferson Station, NY 11776-3364

Mailing address

6 Roosevelt Ave Ste 2
Port Jefferson Station, NY 11776-3364
Phone (631) 474-1533

Other practice location 1

310 Hallock Ave
Port Jefferson Station, NY 11776-1298
Phone (631) 474-1533

Other identifiers 9

IdentifierTypeStateIssuer
205295POtherNYHIP
092104OtherNYVALUE OPTIONS
140237OtherNYVYTRA
561724000OtherNYMAGELLAN
P3557347OtherNYOXFORD
6224668OtherNYUNITED BEHAVIORAL HEALTH
7336342OtherNYGHI
60054OtherNYAETNA
02364309MedicaidNY

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
I20091008000376 NY Practitioner - Clinical Social Worker 1355487158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Roosevelt Ave
Suite 2
Port Jefferson Station, NY 11776-3364
Phone (631) 474-1533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048202-1NYMDClinical Social Worker
048202NYMDPharmacist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1437201498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ROOSEVELT AVE STE 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763364",
            "telephone_number": "631-474-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ROOSEVELT AVE STE 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763364",
            "telephone_number": "631-474-1533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Hallock Ave",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117761298",
            "country_code": "US",
            "telephone_number": "631-474-1533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENT",
        "first_name": "KENNETH",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "048202-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "205295P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "092104",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "140237",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "561724000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3557347",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6224668",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7336342",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02364309",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.