Individual provider Active NPI

Anna Lukianov Jr., LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Bronx, NY
National Provider Identifier
1013571108
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
099916 Issued in NY
Practice address
2488 Grand Concourse RM 417
Bronx, NY 10458-5206
Phone
(718) 584-7204
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 099916 NY Primary

Addresses

Primary practice location

2488 Grand Concourse RM 417
Bronx, NY 10458-5206

Mailing address

2488 Grand Concourse RM 417
Bronx, NY 10458-5206
Phone (718) 584-7204

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
099916NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1013571108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 GRAND CONCOURSE RM 417",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585206",
            "telephone_number": "718-584-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 GRAND CONCOURSE RM 417",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585206",
            "telephone_number": "718-584-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKIANOV",
        "first_name": "ANNA",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "099916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.