Individual provider Active NPI

Harry Ottaway, L.C.S.W.

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1831250778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R028769-1 Issued in NY
Practice address
279 Suffolk Ave
Staten Island, NY 10314-6948
Phone
(718) 370-9068
NPI assigned
Dec 13, 2006
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 R028769-1 NY Primary

Addresses

Primary practice location

279 Suffolk Ave
Staten Island, NY 10314-6948

Mailing address

547 Pelton Ave
Staten Island, NY 10310-2915
Phone (718) 442-4391

Other identifiers 1

IdentifierTypeStateIssuer
7337132OtherNYG.H.I.

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R028769-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831250778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 PELTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102915",
            "telephone_number": "718-442-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUFFOLK AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146948",
            "telephone_number": "718-370-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTAWAY",
        "first_name": "HARRY",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R028769-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G.H.I.",
            "identifier": "7337132",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, 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.