Active NPI
Carol Pavin, LCSW
- Social Worker
- Staten Island, NY
National Provider Identifier
1588696124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- R058729-1
- Practice address
- 1260 Richmond Rd
Staten Island, NY 10304-2304 - Phone
- (718) 667-1416
- Fax
- (718) 983-0348
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | R058729-1 | NY | Primary |
Addresses
Primary practice location
1260 Richmond Rd
Staten Island, NY 10304-2304
Mailing address
100 Colfax Ave
Staten Island, NY 10306-3306
Phone (718) 987-8521
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 554982 | Other | NY | VALUE OPTION |
| P2367187 | Other | NY | OXFORD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R058729-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588696124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 COLFAX AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103063306",
"telephone_number": "718-987-8521",
"fax_number": "718-983-0348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 RICHMOND RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103042304",
"telephone_number": "718-667-1416",
"fax_number": "718-983-0348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVIN",
"first_name": "CAROL",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "R058729-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTION",
"identifier": "554982",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2367187",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.