Individual provider Active NPI

George Medellin Torres, L.C.S.W,

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1972724284
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072281-1 Issued in NY
Practice address
669 Castleton Ave
Staten Island, NY 10301-2028
Phone
(718) 442-2225
Fax
(718) 442-2289
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 072281-1 NY Primary

Addresses

Primary practice location

669 Castleton Ave
Staten Island, NY 10301-2028

Mailing address

150 Coale Ave
Staten Island, NY 10314-2829
Phone (718) 818-0287

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
I20230627001356 NY Practitioner - Clinical Social Worker 3173981958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072281NYMDSocial Worker
072281-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Counseling Center Inc CurrentSince Jun 1, 2023 Accepting new patients

Locations

445 Oak St
Copiague, NY 11726
Phone (631) 257-5173

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

50 W Hawthorne Ave
Valley Stream, NY 11580
Phone (516) 872-9698

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972724284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COALE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142829",
            "telephone_number": "718-818-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225",
            "fax_number": "718-442-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "GEORGE",
        "middle_name": "MEDELLIN",
        "credential": "L.C.S.W,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072281-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.