Individual provider Active NPI

Rene Stockton, MSW

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1992958193
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6435 Yellowstone Blvd Apt 5E
C/O Kenneth Bourne
Forest Hills, NY 11375-1720
Phone
(646) 652-7133
NPI assigned
Oct 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Poetry Therapist 102X00000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6435 Yellowstone Blvd Apt 5E
C/O Kenneth Bourne
Forest Hills, NY 11375-1720

Mailing address

6435 Yellowstone Blvd Apt 5E
C/O Kenneth Bourne
Forest Hills, NY 11375-1720
Phone (646) 652-7133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230509002334 IL Practitioner - Clinical Social Worker 1456717867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 5, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1992958193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 YELLOWSTONE BLVD APT 5E",
            "address_2": "C/O KENNETH BOURNE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751720",
            "telephone_number": "646-652-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 YELLOWSTONE BLVD APT 5E",
            "address_2": "C/O KENNETH BOURNE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751720",
            "telephone_number": "646-652-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102X00000X",
            "taxonomy_group": "",
            "desc": "Poetry Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.