Individual provider Active NPI

Fern Slovin Rudorfer, LICSW

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1609983832
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R021626-1 Issued in NY
Practice address
3924 Avenue T
Brooklyn, NY 11234-5028
Phone
(718) 252-0958
NPI assigned
Aug 24, 2006
Last updated
Aug 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R021626-1 NY Primary

Addresses

Primary practice location

3924 Avenue T
Brooklyn, NY 11234-5028

Mailing address

3924 Avenue T
Brooklyn, NY 11234-5028
Phone (718) 252-0958

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

LicenseStateTypeSpecialty
R021626-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board for Family and Children Services Past Accepting new patients
Servicenet Inc PastSince Feb 4, 2021 Accepting new patients
Jewish Board of Family and Children's Services, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1609983832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 AVENUE T",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345028",
            "telephone_number": "718-252-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 AVENUE T",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345028",
            "telephone_number": "718-252-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDORFER",
        "first_name": "FERN",
        "middle_name": "SLOVIN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R021626-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.