Gregg Klot, LCSW, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R037061-1 Issued in NY

Practice address

135 Prospect Park SW Apt F1
Brooklyn, NY 11218-1266

Phone

(917) 653-7260

Fax

(917) 653-7260

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 28, 2019 through Oct 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1629160304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PROSPECT PARK SW APT F1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181266",
            "telephone_number": "917-653-7260",
            "fax_number": "917-653-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PROSPECT PARK SW APT F1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181266",
            "telephone_number": "917-653-7260",
            "fax_number": "917-653-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOT",
        "first_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "LCSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105214",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "QL-0011916",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "11464",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06012900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R037061-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klopman LLC
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• Jenna Hope Klorfein
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• Rachel Kloss
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• Avery Radclyffe Klotsche, LCSW
• Marina Klotsman, DO
• Tatiana Klozner, PHARMD
• Kluchik RX Corp.

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.