Individual provider Active NPI

Lawrence Iannotti, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1689748857
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R048006 Issued in NY
Practice address
875 Avenue of the Americas RM 1705
New York, NY 10001-3507
Phone
(212) 465-1917
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R048006 NY Primary

Addresses

Primary practice location

875 Avenue of the Americas RM 1705
New York, NY 10001-3507

Mailing address

875 Avenue of the Americas RM 1705
New York, NY 10001-3507
Phone (212) 465-1917

Other identifiers 1

IdentifierTypeStateIssuer
R048006OtherNYLICENSE

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
I20111206000707 NY Practitioner - Clinical Social Worker 6406021211 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

875 Ave of the Americas
RM 1705
New York, NY 10001-3576
Phone (212) 465-1917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R048006NYMDClinical Social Worker
048006NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689748857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 AVENUE OF THE AMERICAS RM 1705",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013507",
            "telephone_number": "212-465-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 AVENUE OF THE AMERICAS RM 1705",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013507",
            "telephone_number": "212-465-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNOTTI",
        "first_name": "LAWRENCE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R048006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R048006",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.