Individual provider Active NPI

Charmaine Gentles, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1558459222
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R061226-1 Issued in NY
Practice address
10 Plaza St E
Suite 1C
Brooklyn, NY 11238-4954
Phone
(718) 908-0360
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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 R061226-1 NY Primary

Addresses

Primary practice location

10 Plaza St E
Suite 1C
Brooklyn, NY 11238-4954

Mailing address

1 Vanata CT
Hempstead, NY 11550-1913
Phone (718) 908-0360

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
I20040414001663 NY Practitioner - Clinical Social Worker 3274528872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R061226-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coney Island Medical Practice Plan, P.C. CurrentSince Oct 1, 2023 Accepting new patients
Sea Breeze Podiatry Associates Past Accepting new patients

Locations

2601 Ocean Pkwy
Rm 3N17
Brooklyn, NY 11235
Phone (718) 616-4554

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1558459222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VANATA CT",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115501913",
            "telephone_number": "718-908-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PLAZA ST E",
            "address_2": "SUITE 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384954",
            "telephone_number": "718-908-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTLES",
        "first_name": "CHARMAINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R061226-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.