Active NPI
Reginald Paul, LMSW
- Clinical Social Worker
- Staten Island, NY
National Provider Identifier
1841655065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 088357
- Practice address
- 777 Seaview Ave
Staten Island, NY 10305-3409 - Phone
- (718) 667-2494
- NPI assigned
- Dec 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 088357 | NY | Primary |
Addresses
Primary practice location
777 Seaview Ave
Staten Island, NY 10305-3409
Mailing address
38 N Lynn St
Warwick, NY 10990-1233
Phone (917) 754-0464
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
| License | State | Type | Specialty |
|---|---|---|---|
| 088357 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1841655065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 N LYNN ST",
"city": "WARWICK",
"state": "NY",
"postal_code": "109901233",
"telephone_number": "917-754-0464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053409",
"telephone_number": "718-667-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "REGINALD",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-16",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "088357",
"primary": true
}
],
"identifiers": [],
"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 Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.