Individual provider Active NPI

Caroline H Rudin, LMSW

  • Clinical Social Worker
  • Massapequa, NY
National Provider Identifier
1922694058
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096929 Issued in NY
Practice address
727 N Broadway Ste B1
Massapequa, NY 11758-2348
Phone
(800) 871-5491
NPI assigned
Dec 13, 2020
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 096929 NY Primary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 110357 NY

Addresses

Primary practice location

727 N Broadway Ste B1
Massapequa, NY 11758-2348

Mailing address

6837 Yellowstone Blvd Apt C37
Forest Hills, NY 11375-3404
Phone (718) 764-7199

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
110357NYMDSocial Worker
096929NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1922694058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6837 YELLOWSTONE BLVD APT C37",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753404",
            "telephone_number": "718-764-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N BROADWAY STE B1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582348",
            "telephone_number": "800-871-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDIN",
        "first_name": "CAROLINE",
        "middle_name": "H",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-13",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096929",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "110357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.