Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Richard Wallace Koffler, CASAC

Individual provider Clinical Social Worker · NPI 1154494102

Richard Wallace Koffler, CASAC is a Clinical Social Worker in Bayside, New York. Qualified in 2000, 26 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
26
Licensed in
NY
In the registry since
2006
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Practice location Address checks out

1666 Bell Blvd Apt 724
Bayside, NY 11360-1656
Phone: (917) 597-5592
Fax: (718) 428-2705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R069801 (NY)

Record details

NPI number1154494102
Entity typeIndividual (Type 1)
GenderMale
Credentials CASAC
Sole proprietorYes
NPI enumeratedNovember 16, 2006
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Bayside