Individual provider Active NPI

Ramin Azarm, LCSW

  • Clinical Social Worker
  • Patchogue, NY
National Provider Identifier
1932577301
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089408-1 Issued in NY
Practice address
450 Waverly Ave Ste 11
Patchogue, NY 11772-1555
Phone
(631) 618-5940
NPI assigned
Sep 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 089408-1 NY Primary

Addresses

Primary practice location

450 Waverly Ave Ste 11
Patchogue, NY 11772-1555

Mailing address

21 Grove Dr
Mastic, NY 11950-1603
Phone (631) 618-5940

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
I20200408000496 NY Practitioner - Clinical Social Worker 4688003965 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089408-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Jul 27, 2020 Accepting new patients
Community Counseling & LCSW Services PC Clinical CurrentSince Mar 1, 2020 Accepting new patients
Sun River Health Inc Current Accepting new patients
Clubhouse of Suffolk, Inc Past Accepting new patients
Qureshi Medical Services PLLC PastSince Dec 1, 2024 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

82 Middle Country Rd
Coram, NY 11727
Phone (631) 320-2220

234 Montauk Hwy
Ctr Moriches, NY 11934
Phone (631) 874-0185

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1932577301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GROVE DR",
            "city": "MASTIC",
            "state": "NY",
            "postal_code": "119501603",
            "telephone_number": "631-618-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVE STE 11",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "631-618-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZARM",
        "first_name": "RAMIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089408-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.