Individual provider Active NPI

Nicole Delgiudice, LCSW

  • Clinical Social Worker
  • Glen Cove, NY
National Provider Identifier
1972016814
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0411861 Issued in NY
Practice address
113 Glen Cove Ave
Glen Cove, NY 11542-3438
Phone
(516) 676-2388
Fax
(516) 753-5240
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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 R0411861 NY Primary

Addresses

Primary practice location

113 Glen Cove Ave
Glen Cove, NY 11542-3438

Mailing address

113 Glen Cove Ave
Glen Cove, NY 11542-3438
Phone (516) 676-2388

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
I20230802001710 NY Practitioner - Clinical Social Worker 7012378342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0411861NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Evans Center, Inc CurrentSince Jun 14, 2023 Accepting new patients
Charles Evans Center, Inc. Current Accepting new patients
Charles Evans Center, Inc CurrentSince Jun 14, 2023 Accepting new patients

Locations

857 S Oyster Bay Rd
Bethpage, NY 11714
Phone (516) 622-8888

113 Glen Cove Ave
Glen Cove, NY 11542
Phone (516) 622-8888

Organizations & group practices 3

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": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1972016814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423438",
            "telephone_number": "516-676-2388",
            "fax_number": "516-753-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423438",
            "telephone_number": "516-676-2388",
            "fax_number": "516-753-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGIUDICE",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0411861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.