Simona Chazen, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR0163341 Issued in NY

Practice address

543 North Broadway
Upper Nyack, NY 10960

Phone

(845) 353-2123

Fax

(845) 353-3597

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689799462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 NORTH BROADWAY",
            "city": "UPPER NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-353-2123",
            "fax_number": "845-353-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 NORTH BROADWAY",
            "city": "UPPER NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-353-2123",
            "fax_number": "845-353-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAZEN",
        "first_name": "SIMONA",
        "name_prefix": "Ms.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR0163341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0082622",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS EMPIRE PLAN",
            "identifier": "0082622002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Lewis Baker, LCSW
• Cara A Clark
• Karen Rose Hebert, PHD
• Gail Lovejoy, LCSW
• Gina Trolio, M.A.

• All providers in Upper Nyack, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.