Individual provider Active NPI

Lore Ann Greenfield, LCSW,CASAC

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1972668549
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0367851 Issued in NY
Practice address
900 Walt Whitman Rd Ste 303
Melville, NY 11747-2215
Phone
(631) 786-7601
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 R0367851 NY Primary

Addresses

Primary practice location

900 Walt Whitman Rd Ste 303
Melville, NY 11747-2215

Mailing address

30 Tamara CT
Melville, NY 11747-4146
Phone (631) 786-7601

Other identifiers 1

IdentifierTypeStateIssuer
N2M961MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 14, 2025 through Jan 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R0367851NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1972668549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 TAMARA CT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474146",
            "telephone_number": "631-786-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD STE 303",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472215",
            "telephone_number": "631-786-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "LORE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW,CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0367851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N2M961",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.