Individual provider Active NPI

Ryan Lee David Brown, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1528310646
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083976-1 Issued in NY
Practice address
455 W. 23Rd Street
Suite 1BB
New York, NY 10011
Phone
(646) 926-6900
NPI assigned
Oct 12, 2012
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 087829 NY
Clinical Social Worker 1041C0700X 083976-1 NY Primary

Addresses

Primary practice location

455 W. 23Rd Street
Suite 1BB
New York, NY 10011

Mailing address

455 W. 23Rd Street
Suite 1BB
New York, NY 10011-7702
Phone (646) 926-6900

Other practice location 1

208 W 13th St
New York, NY 10011-7702
Phone (646) 556-9298

Other identifiers 1

IdentifierTypeStateIssuer
1669668224MedicaidNY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
087829NYMDSocial Worker
083976-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1528310646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W. 23RD STREET",
            "address_2": "SUITE 1BB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117702",
            "telephone_number": "646-926-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W. 23RD STREET",
            "address_2": "SUITE 1BB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "646-926-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 W 13th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100117702",
            "country_code": "US",
            "telephone_number": "646-556-9298",
            "fax_number": "646-486-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RYAN",
        "middle_name": "LEE DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "087829",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083976-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669668224",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.