Individual provider Active NPI

Stacy Cara Klein, LCSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1881806990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R053955 Issued in NY
Practice address
10 Long Acre Lane
Dix Hills, NY 11746-7926
Phone
(631) 499-0139
Fax
(631) 486-1938
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R053955 NY Primary

Addresses

Primary practice location

10 Long Acre Lane
Dix Hills, NY 11746-7926

Mailing address

10 Long Acre Lane
Dix Hills, NY 11746-7926
Phone (631) 499-0139

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090126000324 NY Practitioner - Clinical Social Worker 6608930359 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LCSW of New York PLLCGroup PAC ID 7113269010, 63 clinicians

Practice addresses (Care Compare)

14415 68TH Rd
Flushing, NY 11367-1330
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R053955NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Counseling Center Inc CurrentSince May 3, 2021 Accepting new patients
Senior Care Therapy LCSW of New York PLLC Clinical CurrentSince Jul 1, 2022 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

50 W Hawthorne Ave
Valley Stream, NY 11580
Phone (516) 872-9698

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881806990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LONG ACRE LANE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467926",
            "telephone_number": "631-499-0139",
            "fax_number": "631-486-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LONG ACRE LANE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467926",
            "telephone_number": "631-499-0139",
            "fax_number": "631-486-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "STACY",
        "middle_name": "CARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R053955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.