Individual provider Active NPI

Charles Anthony Primeau, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1609214857
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R034167-1 Issued in NY
Practice address
81 Stuyvesant Ave
2L
Brooklyn, NY 11221-2022
Phone
(646) 334-5265
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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 R034167-1 NY Primary

Addresses

Primary practice location

81 Stuyvesant Ave
2L
Brooklyn, NY 11221-2022

Mailing address

81 Stuyvesant Ave
2L
Brooklyn, NY 11221-2022
Phone (646) 334-5265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130829000161 NY Practitioner - Clinical Social Worker 5597908145 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R034167-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1609214857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 STUYVESANT AVE",
            "address_2": "2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112212022",
            "telephone_number": "646-334-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 STUYVESANT AVE",
            "address_2": "2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112212022",
            "telephone_number": "646-334-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMEAU",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R034167-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.