Active NPI
Lynn Ruder, LCSW
- Clinical Social Worker
- Melville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 090770
- Practice address
- 275 Broadhollow Rd Ste 120
Melville, NY 11747-4863 - Phone
- (845) 279-5908
- Fax
- (845) 622-5055
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 090770 | NY | Primary |
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 72 098159 | NY |
Addresses
Primary practice location
275 Broadhollow Rd Ste 120
Melville, NY 11747-4863
Mailing address
667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone (845) 279-5908
Other practice location 1
22 Oakwood Rd
Huntington, NY 11743-4231
Phone (866) 232-7328
Other practice location 2
240 Long Island Ave
Wyandanch, NY 11798-3123
Phone (631) 782-6200
Other practice location 3
5036 Jericho Tpke Ste 203
Commack, NY 11725-2812
Phone (631) 278-9259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090770 | NY | MD | Clinical Social Worker |
| 72 098159 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carmel Psychological Health, PC | Clinical | Current | Accepting new patients |
Locations
667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223
275 Broadhollow Rd
Ste 120
Melville, NY 11747
Phone (631) 323-6872
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": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785369600000",
"number": "1942742101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 STONELEIGH AVE STE 202",
"city": "CARMEL",
"state": "NY",
"postal_code": "105122455",
"telephone_number": "845-279-5908",
"fax_number": "845-622-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 BROADHOLLOW RD STE 120",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474863",
"telephone_number": "845-279-5908",
"fax_number": "845-622-5055"
}
],
"practiceLocations": [
{
"address_1": "22 Oakwood Rd",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "NY",
"postal_code": "117434231",
"country_code": "US",
"telephone_number": "866-232-7328",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "240 Long Island Ave",
"address_purpose": "LOCATION",
"city": "Wyandanch",
"state": "NY",
"postal_code": "117983123",
"country_code": "US",
"telephone_number": "631-782-6200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5036 Jericho Tpke Ste 203",
"address_purpose": "LOCATION",
"city": "Commack",
"state": "NY",
"postal_code": "117252812",
"country_code": "US",
"telephone_number": "631-278-9259",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUDER",
"first_name": "LYNN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2026-07-30",
"certification_date": "2026-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "090770",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "72 098159",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.