Individual provider Active NPI

Stephen Schoenbrot, LCSW

  • Clinical Social Worker
  • Patchogue, NY
National Provider Identifier
1437218971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR019914-1 Issued in NY
Practice address
475 E Main St
Suite 214
Patchogue, NY 11772-3121
Phone
(631) 486-2868
Fax
(631) 858-0237
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PR019914-1 NY Primary

Addresses

Primary practice location

475 E Main St
Suite 214
Patchogue, NY 11772-3121

Mailing address

43 Colby Dr
Dix Hills, NY 11746-8352
Phone (631) 486-2868

Other identifiers 3

IdentifierTypeStateIssuer
0020953OtherNYGHI
P1011059OtherNYOXFORD
060568OtherNYVALUE OPTIONS

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

State licenses

LicenseStateTypeSpecialty
PR019914-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437218971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 COLBY DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468352",
            "telephone_number": "631-486-2868",
            "fax_number": "631-858-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "address_2": "SUITE 214",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "631-486-2868",
            "fax_number": "631-858-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBROT",
        "first_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR019914-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0020953",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1011059",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "060568",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.