Individual provider Active NPI

Blessy M Mathew

  • Clinical Social Worker
  • East Meadow, NY
National Provider Identifier
1912756107
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113105 Issued in NY
Practice address
245 Green Valley Rd
East Meadow, NY 11554-1522
Phone
(516) 707-5754
NPI assigned
May 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 113105 NY
Clinical Social Worker 1041C0700X 113105 NY Primary

Addresses

Primary practice location

245 Green Valley Rd
East Meadow, NY 11554-1522

Mailing address

245 Green Valley Rd
East Meadow, NY 11554-1522
Phone (516) 707-5754

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
113105NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1912756107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 GREEN VALLEY RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541522",
            "telephone_number": "516-707-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 GREEN VALLEY RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541522",
            "telephone_number": "516-707-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "BLESSY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "113105",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "113105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; 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.