Individual provider Active NPI

Harris Isaac Pollack, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1629361076
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082052 Issued in NY
Practice address
160 W 86TH St
New York, NY 10024-4018
Phone
(212) 362-5730
NPI assigned
May 18, 2011
Last updated
May 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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 082052 NY Primary

Addresses

Primary practice location

160 W 86TH St
New York, NY 10024-4018

Mailing address

815 E 14TH St
3L
Brooklyn, NY 11230-2957
Phone (617) 571-4615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180501000515 NY Order and Referring Only - Clinical Social Worker 6002170917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082052NYMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: cpa.harrispollack@142175.advancedmd-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1629361076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E 14TH ST",
            "address_2": "3L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302957",
            "telephone_number": "617-571-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244018",
            "telephone_number": "212-362-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "HARRIS",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.