Individual provider Active NPI

Tatyana Volokitin Pena, LCSW

  • Clinical Social Worker
  • Woodbury, NY
National Provider Identifier
1053544908
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080993 Issued in NY
Practice address
43 Caumsett Woods LN
Woodbury, NY 11797-1245
Phone
(347) 581-6041
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 080993 NY Primary
Clinical Social Worker 1041C0700X 080993-1 NY

Addresses

Primary practice location

43 Caumsett Woods LN
Woodbury, NY 11797-1245

Mailing address

43 Caumsett Woods LN
Woodbury, NY 11797-1245
Phone (347) 581-6041

Other names 1

  • Ms. Tatyana Volokitin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080993-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1053544908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CAUMSETT WOODS LN",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971245",
            "telephone_number": "347-581-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CAUMSETT WOODS LN",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971245",
            "telephone_number": "347-581-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "TATYANA",
        "middle_name": "VOLOKITIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080993",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080993-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATYANA",
            "last_name": "VOLOKITIN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.