Laura Wynn, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107735 Issued in NY

Practice address

1824 Madison Ave
New York, NY 10035-3832

Phone

(212) 423-4200

NPI assigned

Apr 6, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jewish Board of Family & Childrens Services Inc

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1689755662
  Medicare reassignment NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1295729408

  Clinical

  Medicare reassignment NPD
• Jewish Board of Family and Children'S Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Brooklyn, NY
  • NPI 1760173579

  Clinical

  NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1972877017

  Clinical

  NPD

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1841753993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MACDONOUGH ST # 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162507",
            "telephone_number": "205-243-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22004 Linden Blvd",
            "address_purpose": "LOCATION",
            "city": "Cambria Heights",
            "state": "NY",
            "postal_code": "114111621",
            "country_code": "US",
            "telephone_number": "718-712-3358",
            "fax_number": "718-712-3379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "LAURA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-06",
        "last_updated": "2021-06-29",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "107735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejuan Lamont Wynn, OPTICIAN
• Eleanor Grace Wynn, MHC-LP
• Jill J. Wynn, LCSW
• Julia Wynn, MS, CGC
• Kristin Wynn, LCSW
• Laura Wynne, LMSW
• Eudis D Wynns
• Emmett Davis Wynter, MD
• Malissa Wynter, LCSW
• Shaneka Donna Wynter

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.