Active NPI
Loretta Nancy Paulson, LCSW, LP
- Clinical Social Worker
- New York, NY
National Provider Identifier
1750486619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR015721
- Practice address
- 334 W 86TH St
Ste 1a
New York, NY 10024-3106 - Phone
- (212) 595-4111
- Fax
- (917) 441-3553
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR015721 | NY | Primary |
| Psychoanalyst | 102L00000X | 000258-1 | NY | |
| Clinical Social Worker | 1041C0700X | 000589 | CT |
Addresses
Primary practice location
334 W 86TH St
Ste 1a
New York, NY 10024-3106
Mailing address
334 W 86TH St
Ste 1a
New York, NY 10024-3106
Phone (212) 595-4111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LICENSE #: 000258-1 | Other | NY | PSYCHOANALYST #5623568 |
| 000589 | Other | CT | LCSW LICENSE |
| PRO15721-1 | Other | NY | LCSW REGISTRATION CERTIFI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000258-1 | NY | MD | Mental Health Counselor |
| PR015721 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374710400000",
"number": "1750486619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 W 86TH ST",
"address_2": "STE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243106",
"telephone_number": "212-595-4111",
"fax_number": "917-441-3553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 W 86TH ST",
"address_2": "STE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243106",
"telephone_number": "212-595-4111",
"fax_number": "917-441-3553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "LORETTA",
"middle_name": "NANCY",
"name_prefix": "Mrs.",
"credential": "LCSW, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2013-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR015721",
"primary": true
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "000258-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "000589",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOANALYST #5623568",
"identifier": "LICENSE #: 000258-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW LICENSE",
"identifier": "000589",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW REGISTRATION CERTIFI",
"identifier": "PRO15721-1",
"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 Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.