NPIMap

Organization Active NPI

Clinical Therapeutic Support LCSW PC

Doing business as Eating Disorder Recovery Specialists

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1851805345
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083457 Issued in NY
Legal business name
CLINICAL THERAPEUTIC SUPPORT LCSW PC
Doing business as
Eating Disorder Recovery Specialists
Practice address
57 W 57TH St Ste 1101
New York, NY 10019-2814
Phone
(917) 373-4557
NPI assigned
Nov 21, 2017
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Greta Gleissner, LCSWNPI 1881928539
Title
Founder
Phone
(917) 373-4557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 083457 NY Primary

Addresses

Primary practice location

57 W 57TH St Ste 1101
New York, NY 10019-2814

Mailing address

459 Columbus Ave Ste 124
New York, NY 10024-5129
Phone (917) 373-4557

Other names 1

  • Eating Disorder Recovery Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201029001817 NY Part B Supplier - Clinic/Group Practice 3971913112 Receives reassigned benefits from 13 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Tax ID family
Clinical Therapeutic Support LCSW PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

451 W End Ave
Apt 2H
New York, NY 10024
Phone (212) 799-4907

459 Columbus Ave
New York, NY 10024
Phone (212) 994-4921

57 W 57th St
Ste 1101
New York, NY 10019
Phone (800) 381-7340

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1851805345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 COLUMBUS AVE STE 124",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245129",
            "telephone_number": "917-373-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192814",
            "telephone_number": "917-373-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL THERAPEUTIC SUPPORT LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "GLEISSNER",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "917-373-4557",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eating Disorder Recovery Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.