Individual provider Active NPI

Dennis W Slater, LCSW

  • Clinical Social Worker
  • Holbrook, NY
National Provider Identifier
1619043403
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
021742-1 Issued in NY
Practice address
4250 Veterans Memorial Hwy
Suite 215
Holbrook, NY 11741-4000
Phone
(631) 331-7292
Fax
(631) 474-4272
NPI assigned
Nov 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 021742-1 NY Primary

Addresses

Primary practice location

4250 Veterans Memorial Hwy
Suite 215
Holbrook, NY 11741-4000

Mailing address

4250 Veterans Memorial Hwy
Suite 215
Holbrook, NY 11741-4000
Phone (631) 331-7292

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
021742-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619043403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 215",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414000",
            "telephone_number": "631-331-7292",
            "fax_number": "631-474-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 215",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414000",
            "telephone_number": "631-331-7292",
            "fax_number": "631-474-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "DENNIS",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "021742-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.