Individual provider Active NPI

Rebecca Kustin, LMSW

  • Social Worker
  • Massapequa Park, NY
National Provider Identifier
1689561599
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
126060 Issued in NY
Practice address
5100 Sunrise Hwy FL 2
Massapequa Park, NY 11762-2935
Phone
(631) 696-4357
NPI assigned
Jun 23, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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 126060 NY Primary

Addresses

Primary practice location

5100 Sunrise Hwy FL 2
Massapequa Park, NY 11762-2935

Mailing address

1377 Motor Pkwy Ste 102
Islandia, NY 11749-5249

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

State licenses

LicenseStateTypeSpecialty
126060NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1689561599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 102",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 SUNRISE HWY FL 2",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622935",
            "telephone_number": "631-696-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTIN",
        "first_name": "REBECCA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "126060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.