Individual provider Active NPI

Beth Kalenka

  • Social Worker
  • Wantagh, NY
National Provider Identifier
1922614932
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
080311 Issued in NY
Practice address
1051 Wantagh Ave
Wantagh, NY 11793-2109
Phone
(516) 785-0323
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 080311 NY Primary

Addresses

Primary practice location

1051 Wantagh Ave
Wantagh, NY 11793-2109

Mailing address

1051 Wantagh Ave
Wantagh, NY 11793-2109

Other practice location 1

86 Yale St
Williston Park, NY 11596-1339
Phone (516) 375-8614

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
I20220211000902 NY Practitioner - Clinical Social Worker 5890188015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Shore Counseling and Psychological Services, PCGroup PAC ID 5890849434, 11 clinicians

Practice addresses (Care Compare)

3305 Jerusalem Ave
Suite 207
Wantagh, NY 11793-2028
Phone (516) 785-0323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080311NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Counseling and Psychological Services P C CurrentSince Jan 24, 2022 Accepting new patients

Locations

1051 Wantagh Ave
Wantagh, NY 11793
Phone (516) 551-9739

3305 Jerusalem Ave
Ste 207
Wantagh, NY 11793
Phone (516) 785-0323

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1922614932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932109",
            "telephone_number": "516-785-0323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "86 Yale St",
            "address_purpose": "LOCATION",
            "city": "Williston Park",
            "state": "NY",
            "postal_code": "115961339",
            "country_code": "US",
            "telephone_number": "516-375-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALENKA",
        "first_name": "BETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.