Individual provider Active NPI

Christina Mancuso

  • Clinical Social Worker
  • Woodside, NY
National Provider Identifier
1982269759
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088327 Issued in NY
Practice address
4277 65TH PL
Woodside, NY 11377-5054
Phone
(718) 429-2000
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2019

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 088327 NY Primary

Addresses

Primary practice location

4277 65TH PL
Woodside, NY 11377-5054

Mailing address

4277 65TH PL
Woodside, NY 11377-5054
Phone (718) 429-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 31, 2025 through Jul 31, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
088327NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1982269759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4277 65TH PL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775054",
            "telephone_number": "718-429-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 65TH PL",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113775054",
            "telephone_number": "718-429-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "CHRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.