Richard J Mack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73 076339 Issued in NY

Practice address

50 W 23Rd St
9TH Floor
New York, NY 10010-5205

Phone

(212) 989-2990

Fax

(212) 792-6058

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Fifth Avenue Counseling Center, Inc.Group PAC ID 9739246125, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Fifth Avenue Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1801037270
  Medicare reassignment Care Compare group NPD
• New York Association for New Americans, Inc

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1689656027
  NPD (past)
• Stanley R Graham PH D PC

  • Clinical Psychologist
  • New York, NY
  • NPI 1760653760
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224374400000",
    "number": "1700820792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WILLOW ST",
            "address_2": "APT 6A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012200",
            "telephone_number": "646-284-5962",
            "fax_number": "212-792-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W 23RD ST",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105205",
            "telephone_number": "212-989-2990",
            "fax_number": "212-792-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 076339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Mack, FNP-C
• Lian Alana Mack, MD
• Lorina Mack, LMSW
• Nina Grillo-Balthrop Mack, MA, NBC-HWC
• Patricia Fogarty Mack, MD
• Sashane O Mack, COTA
• Tabethah Mack
• Teri Mack, OTR/L
• Theresa Mack, M.D.,
• Marala Mackarey, AUD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2008; 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.