Individual provider Active NPI

Susan Glazer, LCSW

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1487797148
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR020897-1 Issued in NY
Practice address
10245 67TH Rd
Suite 1T
Forest Hills, NY 11375-2665
Phone
(914) 337-6719
NPI assigned
Feb 14, 2007
Sex
Female
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 PR020897-1 NY Primary

Addresses

Primary practice location

10245 67TH Rd
Suite 1T
Forest Hills, NY 11375-2665

Mailing address

1 Stone PL
Suite 305
Bronxville, NY 10708-3426
Phone (914) 337-6719

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
I20071205000265 NY Practitioner - Clinical Social Worker 7012006638 Practice locations: Forest Hills, NY; Bronxville, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020897NYMDCounseling Psychologist
PR020897-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jane Gelsi,PHD ,LCSW PLLC PastSince Dec 13, 2022 Accepting new patients

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487797148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STONE PL",
            "address_2": "SUITE 305",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107083426",
            "telephone_number": "914-337-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10245 67TH RD",
            "address_2": "SUITE 1T",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752665",
            "telephone_number": "914-337-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZER",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR020897-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.