Individual provider Active NPI

Scott E Forsmith, LCSW-R

  • Clinical Social Worker
  • Central Islip, NY
National Provider Identifier
1568796779
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069409-1 Issued in NY
Practice address
10 Dolores PL
Central Islip, NY 11722-2204
Phone
(631) 234-8490
Fax
(631) 234-8490
NPI assigned
Sep 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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 R069409-1 NY Primary

Addresses

Primary practice location

10 Dolores PL
Central Islip, NY 11722-2204

Mailing address

10 Dolores PL
Central Islip, NY 11722-2204
Phone (631) 234-8490

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R069409-1NYMDClinical Social Worker
069409NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1568796779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DOLORES PL",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222204",
            "telephone_number": "631-234-8490",
            "fax_number": "631-234-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOLORES PL",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222204",
            "telephone_number": "631-234-8490",
            "fax_number": "631-234-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSMITH",
        "first_name": "SCOTT",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-22",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069409-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.