Individual provider Active NPI

Lillian Engelson, LCSW

  • Clinical Social Worker
  • Suffern, NY
National Provider Identifier
1790851186
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R059958 Issued in NY
Practice address
64 Bon Aire Circle, P1
Suffern, NY 10901
Phone
(917) 972-7138
Fax
(718) 346-6747
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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 R059958 NY Primary

Addresses

Primary practice location

64 Bon Aire Circle, P1
Suffern, NY 10901

Mailing address

64 Bon Aire Circle, P1
Suffern, NY 10901
Phone (917) 972-7138

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
I20140701002628 NY Practitioner - Clinical Social Worker 8628293826 Reassigns benefits to 1 organization
Practice locations: Suffern, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 Bon Aire Cir
Suffern, NY 10901-7317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R059958NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 10, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 10, 2017 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Organizations & group practices 4

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1790851186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BON AIRE CIRCLE, P1",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "917-972-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BON AIRE CIRCLE, P1",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "917-972-7138",
            "fax_number": "718-346-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELSON",
        "first_name": "LILLIAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.