Individual provider Active NPI

Luz Mariel Oviedo, LCSW

  • Clinical Social Worker
  • Middle Village, NY
National Provider Identifier
1033305982
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079283 Issued in NY
Practice address
7405 Metropolitan Ave Ste 2F
Middle Village, NY 11379-2636
Phone
(917) 773-7637
NPI assigned
Sep 24, 2007
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 075276-1 NY
Clinical Social Worker 1041C0700X 079283 NY Primary

Addresses

Primary practice location

7405 Metropolitan Ave Ste 2F
Middle Village, NY 11379-2636

Mailing address

7405 Metropolitan Ave Ste 2F
Middle Village, NY 11379-2636
Phone (917) 773-7637

Other practice location 1

109 N 12th St # 704
Brooklyn, NY 11249-1002
Phone (888) 711-5532

Other practice location 2

950 Franklin Ave
Garden City, NY 11530-2927
Phone (888) 711-5532

Other identifiers 1

IdentifierTypeStateIssuer
00245029MedicaidNY

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
I20120507000040 NY Practitioner - Clinical Social Worker 1355503574 Reassigns benefits to 1 organization
Practice locations: Middle Village, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7405 Metropolitan Ave
Suite 2F
Middle Village, NY 11379-2699
Phone (888) 711-5532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075276-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Social Butterflies Psychotherapy LCSW PLLC Clinical CurrentSince Jan 1, 2025 Accepting new patients
Creative Care Group Inc Social Worker CurrentSince Feb 15, 2020 Accepting new patients

Locations

109 N 12th St
#704
Brooklyn, NY 11249
Phone (718) 637-6400

109 N 12th St
Ste 704
Brooklyn, NY 11249
Phone (347) 378-3144

7158 Austin St
Ste 102
Forest Hills, NY 11375
Phone (347) 552-9313

950 Franklin Ave
Garden City, NY 11530
Phone (516) 557-6719

7405 Metropolitan Ave
Middle Village, NY 11379
Phone (718) 637-6400

7405 Metropolitan Ave
Ste 2
Middle Village, NY 11379
Phone (718) 201-2456

7405 Metropolitan Ave
Ste 2F
Middle Village, NY 11379
Phone (718) 635-0595

7405 Metropolitan Ave
Ste 2M
Middle Village, NY 11379

7405 Metropolitan Ave
Ste 2RE
Middle Village, NY 11379

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1033305982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 METROPOLITAN AVE STE 2F",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792636",
            "telephone_number": "917-773-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 METROPOLITAN AVE STE 2F",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792636",
            "telephone_number": "917-773-7637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N 12th St # 704",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112491002",
            "country_code": "US",
            "telephone_number": "888-711-5532",
            "fax_number": "718-228-2845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115302927",
            "country_code": "US",
            "telephone_number": "888-711-5532",
            "fax_number": "718-228-2845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVIEDO",
        "first_name": "LUZ",
        "middle_name": "MARIEL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "075276-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

Verify at the official NPI Registry.