Individual provider Active NPI

Keith Brandt Sabin, LCSW-R

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1669463188
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047226-1 Issued in NY
Practice address
417 W 46TH St
Second Floor
New York, NY 10036-3539
Phone
(212) 582-8051
Fax
(212) 582-8051
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R047226-1 NY
Clinical Social Worker 1041C0700X R047226-1 NY Primary

Addresses

Primary practice location

417 W 46TH St
Second Floor
New York, NY 10036-3539

Mailing address

417 W 46TH St
Second Floor
New York, NY 10036-3539
Phone (212) 582-8051

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
I20171129003651 NY Practitioner - Clinical Social Worker 4183981103 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047226-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent'S Mental Health Services Past Accepting new patients
St. Vincent'S Services Past Accepting new patients

Organizations & group practices 2

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1669463188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 46TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100363539",
            "telephone_number": "212-582-8051",
            "fax_number": "212-582-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 46TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100363539",
            "telephone_number": "212-582-8051",
            "fax_number": "212-582-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABIN",
        "first_name": "KEITH",
        "middle_name": "BRANDT",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R047226-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047226-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.