Individual provider Active NPI

Rachel Cunningham, LMSW

  • Social Worker
  • Kings Park, NY
National Provider Identifier
1629525498
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
098075 Issued in NY
Practice address
270 Juniper Rd
Kings Park, NY 11754-3131
Phone
(631) 469-4428
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 098075 NY Primary

Addresses

Primary practice location

270 Juniper Rd
Kings Park, NY 11754-3131

Mailing address

270 Juniper Rd
Kings Park, NY 11754-3131
Phone (631) 469-4428

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
I20210708002204 NY Practitioner - Clinical Social Worker 0345642617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

270 Juniper Rd
Kings Park, NY 11754-3131
Phone (631) 469-4428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
098075NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling & LCSW Services PC CurrentSince Jun 28, 2021 Accepting new patients
Rachel Lynn Cunningham LMSW PC CurrentSince Mar 1, 2022 Accepting new patients
Qureshi Medical Services PLLC PastSince Dec 1, 2024 Accepting new patients

Locations

408 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-0185

234 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-0185

Organizations & group practices 3

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1629525498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 JUNIPER RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543131",
            "telephone_number": "631-469-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 JUNIPER RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543131",
            "telephone_number": "631-469-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "RACHEL",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "098075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

Verify at the official NPI Registry.