Individual provider Active NPI

Altamease Middleton Clay, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1629125802
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
035177-1 Issued in NY
Practice address
14732 Jamaica Ave
Jamaica, NY 11435-4042
Phone
(718) 526-8400
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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 035177-1 NY Primary

Addresses

Primary practice location

14732 Jamaica Ave
Jamaica, NY 11435-4042

Mailing address

9201 212TH St
Queens Village, NY 11428-1117
Phone (646) 238-5765

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
035177-1NYMDClinical Social Worker
035177NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Transitional Services for New York,Inc. PastSince Mar 28, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1629125802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 212TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281117",
            "telephone_number": "646-238-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14732 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354042",
            "telephone_number": "718-526-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON CLAY",
        "first_name": "ALTAMEASE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "035177-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.