Individual provider Active NPI

Constance Ann Quinn, LCSW-R, DSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1720145154
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0561621 Issued in NY
Practice address
111 8TH Ave
Suite 810
New York, NY 10011-5201
Phone
(212) 624-1080
Fax
(917) 591-6490
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 122803 MA
Clinical Social Worker 1041C0700X 0561621 NY Primary

Addresses

Primary practice location

111 8TH Ave
Suite 810
New York, NY 10011-5201

Mailing address

111 8TH Ave
Suite 810
New York, NY 10011-5201
Phone (212) 624-1080

Other practice location 1

53 State St
Boston, MA 02109-2820
Phone (617) 903-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250110002640 OH Practitioner - Clinical Social Worker 0446359905 Reassigns benefits to 1 organization
I20250327000442 MA Practitioner - Clinical Social Worker 0446359905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122803MAMDClinical Social Worker
0561621NYMDClinical Social Worker
069781NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince May 19, 2025 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince May 19, 2025 Accepting new patients
Ohio State University - Cap CurrentSince Feb 3, 2025 Accepting new patients
Mass General Brigham Community Physicians Inc. Current Accepting new patients
Nysarc Inc Sullivan County Chapter Past Accepting new patients
One Medical of Ny, P.C. Past Accepting new patients
One Medical Group, PC Past Accepting new patients
Nysarc, Inc. Dutchess County Chapter PastSince Mar 10, 2010 Accepting new patients

Locations

53 State St
Ste 106
Boston, MA 02109

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

3870 Townsfair Way
#103B
Columbus, OH 43219

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1720145154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 8TH AVE",
            "address_2": "SUITE 810",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115201",
            "telephone_number": "212-624-1080",
            "fax_number": "917-591-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 8TH AVE",
            "address_2": "SUITE 810",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115201",
            "telephone_number": "212-624-1080",
            "fax_number": "917-591-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 State St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021092820",
            "country_code": "US",
            "telephone_number": "617-903-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CONSTANCE",
        "middle_name": "ANN",
        "credential": "LCSW-R, DSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122803",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0561621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.