Individual provider Active NPI

Gene Yellin, CSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1801011010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR016118 Issued in NY
Practice address
24 E 12TH St RM 505
New York, NY 10003-4560
Phone
(212) 924-2370
Fax
(212) 564-4067
NPI assigned
Apr 13, 2007
Sex
Male
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 PR016118 NY Primary

Addresses

Primary practice location

24 E 12TH St RM 505
New York, NY 10003-4560

Mailing address

400 W 43Rd St Apt 33D
New York, NY 10036-6301
Phone (212) 564-4067

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PR016118NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801011010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 43RD ST APT 33D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100366301",
            "telephone_number": "212-564-4067",
            "fax_number": "212-564-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST RM 505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034560",
            "telephone_number": "212-924-2370",
            "fax_number": "212-564-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIN",
        "first_name": "GENE",
        "name_prefix": "Mr.",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR016118",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.