Individual provider Active NPI

Kaitlin Tangredi, LCSW

  • Clinical Social Worker
  • New Hyde Park, NY
National Provider Identifier
1528894896
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099573 Issued in NY
Practice address
410 Lakeville Rd Ste 200
New Hyde Park, NY 11042-1103
Phone
(516) 708-2520
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 109943 NY
Clinical Social Worker 1041C0700X 099573 NY Primary

Addresses

Primary practice location

410 Lakeville Rd Ste 200
New Hyde Park, NY 11042-1103

Mailing address

410 Lakeville Rd Ste 200
New Hyde Park, NY 11042-1103
Phone (516) 708-2520

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
I20250811000406 NY Practitioner - Clinical Social Worker 0648778522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Visiting Counselors LCSW PLLCGroup PAC ID 8426393968, 28 clinicians

Practice addresses (Care Compare)

900 Walt Whitman Rd
Suite LL1
Melville, NY 11747-2215
Phone (516) 698-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109943NYMDSocial Worker
099573NYMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Counselors, LCSW, PLLC Clinical CurrentSince Jul 15, 2025 Accepting new patients

Locations

900 Walt Whitman Rd
Ste LL1
Melville, NY 11747
Phone (516) 698-5511

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": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1528894896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421103",
            "telephone_number": "516-708-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD STE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421103",
            "telephone_number": "516-708-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGREDI",
        "first_name": "KAITLIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109943",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.