Individual provider Active NPI

Laura C Nack, LCSW CASAC CEAP

  • Clinical Social Worker
  • Bayside, NY
National Provider Identifier
1750433561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0350691 Issued in NY
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

Updated by the provider on Jul 8, 2007

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 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 Other name

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

LicenseStateTypeSpecialty
R0350691NYMDClinical 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.

Verify at the official NPI Registry.