Individual provider Active NPI

Celestine Tanner, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1770801771
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00079192 Issued in NY
Practice address
19 Union SQ W
7TH Floor
New York, NY 10003-3304
Phone
(212) 627-9600
Fax
(212) 627-4040
NPI assigned
May 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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 00079192 NY Primary

Addresses

Primary practice location

19 Union SQ W
7TH Floor
New York, NY 10003-3304

Mailing address

19 Union SQ W
7TH Floor
New York, NY 10003-3304
Phone (212) 627-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210209000554 NY Practitioner - Clinical Social Worker 4486069218 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00079192NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Realization Center Past Accepting new patients
Realization Center, Inc. PastSince Sep 1, 2015 Accepting new patients

Organizations & group practices 2

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": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1770801771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 UNION SQ W",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033304",
            "telephone_number": "212-627-9600",
            "fax_number": "212-627-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 UNION SQ W",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033304",
            "telephone_number": "212-627-9600",
            "fax_number": "212-627-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "CELESTINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "00079192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.