Individual provider Active NPI

Gabrielle Kleinmann, LCSW-R

  • Clinical Social Worker
  • Woodstock, NY
National Provider Identifier
1700893187
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO28384-1 Issued in NY
Practice address
404 Zena Rd
Woodstock, NY 12498-2626
Phone
(845) 679-8484
Fax
(845) 679-5485
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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 RO28384-1 NY Primary

Addresses

Primary practice location

404 Zena Rd
Woodstock, NY 12498-2626

Mailing address

404 Zena Rd
Woodstock, NY 12498-2626
Phone (845) 679-8650

Other identifiers 2

IdentifierTypeStateIssuer
W17561OtherNYEMPIRE
617425OtherNYMVP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO28384-1NYMDClinical Social Worker
028384NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1700893187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-8650",
            "fax_number": "845-679-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ZENA RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-8484",
            "fax_number": "845-679-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINMANN",
        "first_name": "GABRIELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO28384-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "W17561",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "617425",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.