Individual provider Active NPI

Melissa Behrens, LCSWR

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1447502919
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082441 Issued in NY
Practice address
1500 Waters Place
Bronx, NY 10461-2723
Phone
(929) 348-3328
Fax
(929) 348-3158
NPI assigned
Oct 9, 2012
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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 082441 NY Primary

Addresses

Primary practice location

1500 Waters Place
Bronx, NY 10461-2723

Mailing address

1500 Waters Place
Bronx, NY 10461-2723
Phone (929) 348-3328

Other identifiers 1

IdentifierTypeStateIssuer
03004280MedicaidNY

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
I20241121001186 NY Order and Referring Only - Clinical Social Worker 1850613050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082441NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1447502919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WATERS PLACE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612723",
            "telephone_number": "929-348-3328",
            "fax_number": "929-348-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WATERS PLACE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612723",
            "telephone_number": "929-348-3328",
            "fax_number": "929-348-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "MELISSA",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2024-11-15",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03004280",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.