Individual provider Active NPI

Vanessa Bryan

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1679004816
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086649 Issued in NY
Practice address
810 Classon Ave
Brooklyn, NY 11238-6102
Phone
(516) 668-1723
NPI assigned
Mar 21, 2017
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 086649 NY Primary

Addresses

Primary practice location

810 Classon Ave
Brooklyn, NY 11238-6102

Mailing address

842 Troy St
Elmont, NY 11003-5004
Phone (516) 668-1723

Other names 1

  • Vanessa Williams Former name

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
I20190419000122 NY Practitioner - Clinical Social Worker 1254673353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086649NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Apr 8, 2019 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Apr 8, 2019 Accepting new patients

Locations

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1679004816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 TROY ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110035004",
            "telephone_number": "516-668-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CLASSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386102",
            "telephone_number": "516-668-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "WILLIAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.