Individual provider Active NPI

Richard Michael Dobbins, LCSW

  • Clinical Social Worker
  • Rego Park, NY
National Provider Identifier
1871271940
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091479 Issued in NY
Practice address
9939 66TH Ave
Rego Park, NY 11374-3617
Phone
(917) 331-4762
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 091479 NY Primary

Addresses

Primary practice location

9939 66TH Ave
Rego Park, NY 11374-3617

Mailing address

85 E End Ave Apt 14C
New York, NY 10028-8091
Phone (917) 331-4762

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
091479NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1871271940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 E END AVE APT 14C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100288091",
            "telephone_number": "917-331-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 66TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743617",
            "telephone_number": "917-331-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBINS",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.