Individual provider Active NPI

Aleksandar Ljubicic, LCSW-R

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1023030541
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R059740-1 Issued in NY
Practice address
623 W 170TH St
#3D
New York, NY 10032-3213
Phone
(212) 543-1868
Fax
(212) 543-1868
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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 R059740-1 NY Primary

Addresses

Primary practice location

623 W 170TH St
#3D
New York, NY 10032-3213

Mailing address

617 W 170TH St Apt 2B
New York, NY 10032-3207
Phone (646) 283-5461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051003000888 NY Practitioner - Clinical Social Worker 2567497092 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R059740-1NYMDClinical Social Worker
059740NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Soulutions Psychotherapy Clinical Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1023030541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 W 170TH ST APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323207",
            "telephone_number": "646-283-5461",
            "fax_number": "212-543-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W 170TH ST",
            "address_2": "#3D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323213",
            "telephone_number": "212-543-1868",
            "fax_number": "212-543-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUBICIC",
        "first_name": "ALEKSANDAR",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059740-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.