Active NPI
Gerald Joseph Bowen, LCSW
- Clinical Social Worker
- North Bellmore, NY
National Provider Identifier
1558538116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR024091-1
- Practice address
- 2415 Jerusalem Ave
Suite 105
North Bellmore, NY 11710-1870 - Phone
- (516) 679-1535
- NPI assigned
- May 13, 2008
- Last updated
- Aug 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR024091-1 | NY | Primary |
Addresses
Primary practice location
2415 Jerusalem Ave
Suite 105
North Bellmore, NY 11710-1870
Mailing address
2415 Jerusalem Ave
Suite 105
North Bellmore, NY 11710-1870
Phone (516) 679-1535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 10, 2021 through Jun 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024091 | NY | MD | Clinical Psychologist |
| PR024091-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376524800000",
"number": "1558538116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 JERUSALEM AVE",
"address_2": "SUITE 105",
"city": "NORTH BELLMORE",
"state": "NY",
"postal_code": "117101870",
"telephone_number": "516-679-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 JERUSALEM AVE",
"address_2": "SUITE 105",
"city": "NORTH BELLMORE",
"state": "NY",
"postal_code": "117101870",
"telephone_number": "516-679-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "GERALD",
"middle_name": "JOSEPH",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-13",
"last_updated": "2013-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR024091-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bellmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.