Icaro Otavio Nogueira Soares, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

106794 Issued in NY

Practice address

57 Saint Marks PL
New York, NY 10003-7902

Phone

(212) 982-3470

NPI assigned

Jul 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1043862055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SAINT MARKS PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100037902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SAINT MARKS PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100037902",
            "telephone_number": "212-982-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOGUEIRA SOARES",
        "first_name": "ICARO",
        "middle_name": "OTAVIO",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brooklyn",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "821 Raymond Ave Ste 200B",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551141503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lourdie Noezile Sergiles
• Ralph V. Nofi, PSY.D.
• Noga Harizman MD PC
• Karla-Hannah Nogais
• Jennifer Nogi, MD
• Selin Fatma Nogueira-Zorer
• Bernadine Pestio Noguera, OT
• Claudia Noguera
• Christine Nogueras, NP
• Juan Carlos Nogues, MD

• Social Worker in New York, NY
• Providers in New York, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.