Active NPI
Lee Brockman Welch, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1619309507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R053514
- Practice address
- 460 W 24TH St Apt 1F
New York, NY 10011-1366 - Phone
- (212) 242-6920
- NPI assigned
- Aug 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R053514 | NY | Primary |
Addresses
Primary practice location
460 W 24TH St Apt 1F
New York, NY 10011-1366
Mailing address
460 W 24TH St Apt 1F
New York, NY 10011-1366
Phone (212) 242-6920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260324001837 | OR | Practitioner - Clinical Social Worker | 8224512678 | Practice locations: Portland, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Portland, OR 97217
Phone (917) 697-9325
2012 N Alberta St
Portland, OR 97217-3505
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R053514 | NY | MD | Clinical Social Worker |
| 053514 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375401600000",
"number": "1619309507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 W 24TH ST APT 1F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111366",
"telephone_number": "212-242-6920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 W 24TH ST APT 1F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111366",
"telephone_number": "212-242-6920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELCH",
"first_name": "LEE",
"middle_name": "BROCKMAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-02",
"last_updated": "2013-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R053514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.