NPIMap

Organization Active NPI

Visiting Counselors of New York, LCSW, PLLC

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1669906889
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085396-1 Issued in NY
Legal business name
VISITING COUNSELORS OF NEW YORK, LCSW, PLLC
Practice address
900 Walt Whitman Rd Ste LL1
Melville, NY 11747
Phone
(516) 698-5511
Fax
(516) 418-5377
NPI assigned
Apr 13, 2017
Last updated
Jan 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Russell Chertok, LCSWNPI 1851631782
Title
Owner
Phone
(516) 698-5511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 085396-1 NY Primary

Addresses

Primary practice location

900 Walt Whitman Rd Ste LL1
Melville, NY 11747

Mailing address

900 Walt Whitman Rd Ste LL1
Melville, NY 11747-2215
Phone (516) 698-5511

Other practice location 1

3 Wren Dr
Hauppauge, NY 11788-1106
Phone (516) 698-5511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171211001077 NY Part B Supplier - Clinic/Group Practice 4688932106 Receives reassigned benefits from 45 practitioners
Practice locations: Melville, NY

National Provider Directory

National Provider Directory
Tax ID family
Licensed Master Social Work Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

900 Walt Whitman Rd
Melville, NY 11747
Phone (516) 698-5511

900 Walt Whitman Rd
Ste LL1
Melville, NY 11747
Phone (516) 698-5511

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1669906889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD STE LL1",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472215",
            "telephone_number": "516-698-5511",
            "fax_number": "516-418-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD STE LL1",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "516-698-5511",
            "fax_number": "516-418-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Wren Dr",
            "address_purpose": "LOCATION",
            "city": "Hauppauge",
            "state": "NY",
            "postal_code": "117881106",
            "country_code": "US",
            "telephone_number": "516-698-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISITING COUNSELORS OF NEW YORK, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "CHERTOK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-698-5511",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085396-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.