Individual provider Active NPI

Matthew Pieknik

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1013459775
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092593 Issued in NY
Practice address
5 W 19TH St FL 3
New York, NY 10011-4238
Phone
(917) 891-0144
NPI assigned
Nov 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 092593 NY Primary

Addresses

Primary practice location

5 W 19TH St FL 3
New York, NY 10011-4238

Mailing address

5 W 19TH St FL 3
New York, NY 10011-4238
Phone (917) 891-0144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
092593NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Pieknik LCSW Clinical CurrentSince Jul 21, 2024 Accepting new patients
New York Pathways Therapy Services, LCSW PLLC Clinical Past Accepting new patients

Locations

5 W 19th St
Fl 3
New York, NY 10011
Phone (917) 656-6366

Organizations & group practices 2

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": "1478908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1013459775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W 19TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114238",
            "telephone_number": "917-891-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W 19TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114238",
            "telephone_number": "917-891-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEKNIK",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-12",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.