Individual provider Active NPI

Kenneth S Greenwald, LCSW

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1740495266
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
R071074-1 Issued in NY
Practice address
336 W End Ave
Suite 19a
New York, NY 10023-8116
Phone
(212) 724-5510
Fax
(212) 724-5510
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X R071074-1 NY Primary

Addresses

Primary practice location

336 W End Ave
Suite 19a
New York, NY 10023-8116

Mailing address

336 W End Ave
Suite 19a
New York, NY 10023-8116
Phone (212) 724-5510

Other identifiers 1

IdentifierTypeStateIssuer
R071074-1OtherNYNEW YORK STATE

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
R071074-1NYMDPsychoanalyst
059326NYMDPharmacist
071074NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1740495266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W END AVE",
            "address_2": "SUITE 19A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238116",
            "telephone_number": "212-724-5510",
            "fax_number": "212-724-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W END AVE",
            "address_2": "SUITE 19A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238116",
            "telephone_number": "212-724-5510",
            "fax_number": "212-724-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "KENNETH",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "R071074-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE",
            "identifier": "R071074-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.