Individual provider Active NPI

Richard Joseph Klosek, M.S.W.

  • Clinical Social Worker
  • White Plains, NY
National Provider Identifier
1588796387
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R052316-2 Issued in NY
Practice address
1230 Mamaroneck Ave
Suite 200
White Plains, NY 10605-5229
Phone
(914) 637-9691
Fax
(914) 637-9684
NPI assigned
Mar 9, 2007
Last updated
Feb 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 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 R052316-2 NY Primary

Addresses

Primary practice location

1230 Mamaroneck Ave
Suite 200
White Plains, NY 10605-5229

Mailing address

1230 Mamaroneck Ave
Suite 200
White Plains, NY 10605-5229
Phone (914) 637-9691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 27, 2018 through Jun 27, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R052316-2NYMDClinical Social Worker
052316NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1588796387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 MAMARONECK AVE",
            "address_2": "SUITE 200",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055229",
            "telephone_number": "914-637-9691",
            "fax_number": "914-637-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 MAMARONECK AVE",
            "address_2": "SUITE 200",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055229",
            "telephone_number": "914-637-9691",
            "fax_number": "914-637-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSEK",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R052316-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.