Active NPI
Aleksandar Ljubicic, LCSW-R
- Clinical Social Worker
- New York, NY
National Provider Identifier
1023030541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R059740-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051003000888 | NY | Practitioner - Clinical Social Worker | 2567497092 | Practice locations: New York, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R059740-1 | NY | MD | Clinical Social Worker |
| 059740 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Clinical Social Worker
- New York, NY
- NPI 1275751836
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.