Individual provider Active NPI

David Feder, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1962012484
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096905 Issued in NY
Practice address
41 Union SQ W Ste 1523
New York, NY 10003-3250
Phone
(415) 676-1850
NPI assigned
Aug 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 109822 NY
Clinical Social Worker 1041C0700X 096905 NY Primary

Addresses

Primary practice location

41 Union SQ W Ste 1523
New York, NY 10003-3250

Mailing address

41 Union SQ W Ste 1523
New York, NY 10003-3250
Phone (415) 676-1850

Other practice location 1

41 Union Sq W Ste 1523
New York, NY 10003-3250

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
109822NYMDSocial Worker
096905NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
David Feder LCSW PLLC Clinical CurrentSince Oct 13, 2024 Accepting new patients
Center for Personal Growth & Wellness LLC PastSince Aug 1, 2020 Accepting new patients

Locations

41 Union Sq W
Ste 1523
New York, NY 10003
Phone (212) 675-7020

Organizations & group practices 2

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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1962012484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 UNION SQ W STE 1523",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033250",
            "telephone_number": "415-676-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 UNION SQ W STE 1523",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033250",
            "telephone_number": "415-676-1850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Union Sq W Ste 1523",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033250",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDER",
        "first_name": "DAVID",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-10",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "109822",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.