Individual provider Active NPI

Stacey Flatow, LCSW

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1780908293
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084006-1 Issued in NY
Practice address
7025 Yellowstone Blvd Apt 20F
Forest Hills, NY 11375-3179
Phone
(516) 282-6301
NPI assigned
Mar 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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 084006-1 NY Primary

Addresses

Primary practice location

7025 Yellowstone Blvd Apt 20F
Forest Hills, NY 11375-3179

Mailing address

7025 Yellowstone Blvd Apt 20F
Forest Hills, NY 11375-3179
Phone (516) 282-6301

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
I20230814000772 NY Practitioner - Clinical Social Worker 5991167637 Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084006-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1780908293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 YELLOWSTONE BLVD APT 20F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753179",
            "telephone_number": "516-282-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 YELLOWSTONE BLVD APT 20F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753179",
            "telephone_number": "516-282-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATOW",
        "first_name": "STACEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084006-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.