Individual provider Active NPI

Lori N Gralnick, LCSW

  • Clinical Social Worker
  • Ridge, NY
National Provider Identifier
1982769816
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R026306-1 Issued in NY
Practice address
22 Villanova CT
Ridge, NY 11961-1634
Phone
(631) 849-1853
Fax
(347) 234-5922
NPI assigned
Dec 22, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 R026306-1 NY Primary

Addresses

Primary practice location

22 Villanova CT
Ridge, NY 11961-1634

Mailing address

22 Villanova CT
Ridge, NY 11961-1634
Phone (631) 849-1853

Other identifiers 2

IdentifierTypeStateIssuer
146720OtherNYVALUE OPTIONS
7402652OtherNYGHI

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
I20111022000032 NY Practitioner - Clinical Social Worker 8123291937 Practice locations: Ridge, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Ridge, NY 11961
Phone (631) 849-1853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R026306-1NYMDClinical Social Worker
026306NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1982769816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 VILLANOVA CT",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119611634",
            "telephone_number": "631-849-1853",
            "fax_number": "347-234-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 VILLANOVA CT",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119611634",
            "telephone_number": "631-849-1853",
            "fax_number": "347-234-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRALNICK",
        "first_name": "LORI",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R026306-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "146720",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7402652",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridge, NY

Sources for this page

Verify at the official NPI Registry.