Active NPI
Laura C Nack, LCSW CASAC CEAP
- Clinical Social Worker
- Bayside, NY
National Provider Identifier
1750433561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0350691
- Practice address
- 2350 Waters Edge Dr
S 1E
Bayside, NY 11360 - Phone
- (718) 631-2416
- Fax
- (718) 631-2416
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- 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 | R0350691 | NY | Primary |
Addresses
Primary practice location
2350 Waters Edge Dr
S 1E
Bayside, NY 11360
Mailing address
1840 211 Street
Bayside, NY 11360
Phone (718) 631-2416
Other names 1
- Ms. Laura Cohen
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 |
|---|---|---|---|
| R0350691 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750433561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 211 STREET",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11360",
"telephone_number": "718-631-2416",
"fax_number": "718-428-1024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 WATERS EDGE DR",
"address_2": "S 1E",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11360",
"telephone_number": "718-631-2416",
"fax_number": "718-631-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACK",
"first_name": "LAURA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "LCSW CASAC CEAP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0350691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "COHEN",
"prefix": "MS.",
"credential": "MS ED",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.