Active NPI
Chris Constance Jr., LCSW
- Clinical Social Worker
- Blauvelt, NY
National Provider Identifier
1720006513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R034131-1
- Practice address
- 28 Moehring Dr
Blauvelt, NY 10913-2009 - Phone
- (845) 359-8472
- Fax
- (845) 359-8472
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R034131-1 | NY | Primary |
Addresses
Primary practice location
28 Moehring Dr
Blauvelt, NY 10913-2009
Mailing address
28 Moehring Dr
Blauvelt, NY 10913-2009
Phone (845) 359-8472
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R034131-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1720006513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 MOEHRING DR",
"city": "BLAUVELT",
"state": "NY",
"postal_code": "109132009",
"telephone_number": "845-359-8472",
"fax_number": "845-359-8472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 MOEHRING DR",
"city": "BLAUVELT",
"state": "NY",
"postal_code": "109132009",
"telephone_number": "845-359-8472",
"fax_number": "845-359-8472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONSTANCE",
"first_name": "CHRIS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R034131-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blauvelt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.