Individual provider Active NPI

Andrew Jacob Rosen

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1639892581
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
379 Washington Ave Apt 1E
Brooklyn, NY 11238-1126
Phone
(603) 493-5210
NPI assigned
Sep 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 Primary

Addresses

Primary practice location

379 Washington Ave Apt 1E
Brooklyn, NY 11238-1126

Mailing address

379 Washington Ave Apt 1E
Brooklyn, NY 11238-1126
Phone (603) 493-5210

Other practice location 1

1 N Front St
Kingston, NY 12401-3813
Phone (845) 679-8650

Other practice location 2

404 Zena Rd
Woodstock, NY 12498-2626
Phone (845) 679-8650

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maverick Family Counseling Past 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": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1639892581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 WASHINGTON AVE APT 1E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381126",
            "telephone_number": "603-493-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 WASHINGTON AVE APT 1E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381126",
            "telephone_number": "603-493-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 N Front St",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124013813",
            "country_code": "US",
            "telephone_number": "845-679-8650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 Zena Rd",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "NY",
            "postal_code": "124982626",
            "country_code": "US",
            "telephone_number": "845-679-8650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ANDREW",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.