Individual provider Active NPI

Carl Tristan Schlichtinger, M.S.W./ L.C.S.W.

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1922163997
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055370 Issued in NY
Practice address
31 1St St
Staten Island, NY 10306-2201
Phone
(718) 667-1258
Fax
(718) 667-1423
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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 R055370 NY Primary

Addresses

Primary practice location

31 1St St
Staten Island, NY 10306-2201

Mailing address

PO Box 80209
Staten Island, NY 10308-0209
Phone (718) 667-1258

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
I20051006000136 NY Practitioner - Clinical Social Worker 7911922257 Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31 1St St
Staten Island, NY 10306-2201
Phone (718) 667-1258

97 Durant Ave
Staten Island, NY 10306-3853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055370NYMDClinical Social Worker
055370NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Community Living , Inc. Past Accepting new patients

Organizations & group practices 1

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1922163997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80209",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103080209",
            "telephone_number": "718-667-1258",
            "fax_number": "718-667-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 1ST ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062201",
            "telephone_number": "718-667-1258",
            "fax_number": "718-667-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICHTINGER",
        "first_name": "CARL",
        "middle_name": "TRISTAN",
        "name_prefix": "Mr.",
        "credential": "M.S.W./ L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.