Individual provider Active NPI

Loren Ecker, LCSW

  • Clinical Social Worker
  • Flushing, NY
National Provider Identifier
1700174992
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079419-1 Issued in NY
Practice address
14003 69TH Ave
Flushing, NY 11367-1636
Phone
(917) 587-8853
NPI assigned
Jul 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 076771-1 NY
Clinical Social Worker 1041C0700X 079419-1 NY Primary

Addresses

Primary practice location

14003 69TH Ave
Flushing, NY 11367-1636

Mailing address

14003 69TH Ave
Flushing, NY 11367-1636
Phone (917) 587-8853

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
I20120925000156 NY Practitioner - Clinical Social Worker 6507014198 Practice locations: Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14003 69TH Ave
Flushing, NY 11367-1636
Phone (917) 587-8853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076771-1NYMDSocial Worker
079419NYMDClinical Social Worker
079419-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1700174992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14003 69TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671636",
            "telephone_number": "917-587-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14003 69TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671636",
            "telephone_number": "917-587-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKER",
        "first_name": "LOREN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076771-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079419-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.