Leslie Spivak, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R037378-1 Issued in NY

Practice address

60 Fire Island Ave.
Ste. 103
Babylon, NY 11702

Phone

(631) 661-1922

NPI assigned

Apr 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1013135607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FIRE ISLAND AVE",
            "address_2": "STE. 103",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023502",
            "telephone_number": "631-661-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FIRE ISLAND AVE.",
            "address_2": "STE. 103",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-661-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R037378-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Steamy Inc

• Clinical Social Worker in Babylon, NY
• Providers in Babylon, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.