Individual provider Active NPI

Neal Raymond Niznan, LCSW

  • Clinical Social Worker
  • West Conshohocken, PA
National Provider Identifier
1871890624
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015235 Issued in PA
Practice address
100 Four Falls Corporate Ctr
Suit 312
West Conshohocken, PA 19428-2950
Phone
(610) 397-0950
NPI assigned
Feb 14, 2011
Last updated
Feb 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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 CW015235 PA Primary

Addresses

Primary practice location

100 Four Falls Corporate Ctr
Suit 312
West Conshohocken, PA 19428-2950

Mailing address

100 Four Falls Corporate Ctr
Suit 312
West Conshohocken, PA 19428-2950
Phone (610) 397-0950

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
CW015235PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1871890624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOUR FALLS CORPORATE CTR",
            "address_2": "SUIT 312",
            "city": "WEST CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282950",
            "telephone_number": "610-397-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FOUR FALLS CORPORATE CTR",
            "address_2": "SUIT 312",
            "city": "WEST CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282950",
            "telephone_number": "610-397-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIZNAN",
        "first_name": "NEAL",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Conshohocken, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.