Fanchette Grunblatt, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

445 Oak St
Copiague, NY 11726-3111

Phone

(631) 896-7389

NPI assigned

Oct 3, 2020

Last updated

Oct 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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.

Specialty

Clinical Social Worker

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Green Leaf Counseling LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1053282954
  NPD Authorized official

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

{
    "created_epoch": "1601683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1598362576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SKYLINE DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 OAK ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117263111",
            "telephone_number": "631-896-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNBLATT",
        "first_name": "FANCHETTE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-03",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Gomez
• Laura L Gorman
• Diana Elicia Grant, LMHC
• Wanda Green, RN
• David Grossman, RN
• Krishna R S Gujavarty, MD
• Joshua Lee Gutierrez, L.A.C.
• Minako Hara, MA CCC SLP
• Harbor Wellness Spa & Bodyworks ,LTD.
• Jaylen Hardy, LMSW

• Clinical Social Worker in Copiague, NY
• Providers in Copiague, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.