Keith Spencer Bryan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0410061 Issued in NY

Practice address

222 West Market St
Long Beach, NY 11561

Phone

(516) 375-0192

Fax

(516) 889-7899

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871644575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WEST MARKET ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-432-1432",
            "fax_number": "516-889-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WEST MARKET ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "11561",
            "telephone_number": "516-375-0192",
            "fax_number": "516-889-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KEITH",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0410061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Brous, M.A. SPECIAL ED
• Keri Brucato, M.ED.
• Bruce a Fastenberg MD PLLC
• Rosalin Brueck, LMHC
• Samantha Elizabeth Brumfield, LICENSED PRACTICAL N
• Brucha Buff, PA-C
• Jennifer Murray Buonocore, MS, OTR/L
• Tiffani Burks, MA, M.S. ED
• Deborah Cacamese
• Camhi Licensed Behavior Analysis ,PLLC

• Clinical Social Worker in Long Beach, NY
• Providers in Long Beach, 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 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.