NPIMap

Organization Active NPI

Nassau Guidance Counseling & Licensed Clinical Social Work Services PC

  • Clinical Social Worker
  • Merrick, NY
National Provider Identifier
1609923515
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R026117 Issued in NY
Legal business name
NASSAU GUIDANCE COUNSELING & LICENSED CLINICAL SOCIAL WORK SERVICES PC
Practice address
1262 Powell Ave
Merrick, NY 11566-1811
Phone
(516) 829-4891
Fax
(516) 785-5698
NPI assigned
Jan 4, 2007
Last updated
Apr 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Ms. Kathleen Dwyer, LSCW
Title
Director
Phone
(516) 826-4891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X R026117 NY Primary

Addresses

Primary practice location

1262 Powell Ave
Merrick, NY 11566-1811

Mailing address

1262 Powell Ave
Merrick, NY 11566-1811
Phone (516) 829-4891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100428000028 NY Part B Supplier - Clinic/Group Practice 1658408448 Receives reassigned benefits from 32 practitioners
Practice locations: North Bellmore, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1609923515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 POWELL AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661811",
            "telephone_number": "516-829-4891",
            "fax_number": "516-785-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1262 POWELL AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661811",
            "telephone_number": "516-829-4891",
            "fax_number": "516-785-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU GUIDANCE COUNSELING & LICENSED CLINICAL SOCIAL WORK SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-826-4891",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSCW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R026117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.