Individual provider Active NPI

Lorraine Fortune Bertino, PHD, LCSW

  • Clinical Social Worker
  • Sea Cliff, NY
National Provider Identifier
1780719443
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R044684 Issued in NY
Practice address
42 Central Avenue
Sea Cliff, NY 11579-1102
Phone
(516) 676-7442
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 R044684 NY Primary

Addresses

Primary practice location

42 Central Avenue
Sea Cliff, NY 11579-1102

Mailing address

42 Central Ave
Sea Cliff, NY 11579-1102
Phone (516) 676-7442

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
I20211108000265 NY Practitioner - Clinical Social Worker 2860881158 Practice locations: Glen Head, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Depot PL
Glen Head, NY 11545-1706
Phone (516) 241-6391

2 Depot Place
Glen Head, NY 11545-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R044684NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780719443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CENTRAL AVE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791102",
            "telephone_number": "516-676-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CENTRAL AVENUE",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115791102",
            "telephone_number": "516-676-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTINO",
        "first_name": "LORRAINE",
        "middle_name": "FORTUNE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R044684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Cliff, NY

Sources for this page

Verify at the official NPI Registry.