Carla Leah Brajkovic, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R067003 Issued in NY

Practice address

260 N Little Tor Rd
New City, NY 10956-2627

Phone

(845) 999-3060

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Carla Leah Jacobelli Former name

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jawonio Inc

  • Early Intervention Provider Agency
  • New City, NY
  • NPI 1235209065
  NPD
• Jawonio Inc

  • Community/Behavioral Health Agency
  • Spring Valley, NY
  • NPI 1417235946
  NPD
• Catholic Charities Neighborhood Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1548373921
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1063443372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W STE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181370",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 N LITTLE TOR RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562627",
            "telephone_number": "845-999-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAJKOVIC",
        "first_name": "CARLA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R067003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "JACOBELLI",
            "middle_name": "LEAH",
            "prefix": "MS.",
            "credential": "LCSW-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melvin B Borg, D.D.S.
• Margaret Borno
• Alyssa Boudreau, PT
• Brain Sign ABA LLC
• Monique Braithwaite
• Richard David Brand, MD
• Hadassah Brandspiegel
• Anna Nicolina Branquinho, OTR
• Faith Brennan, OTR
• Susan Irene Brennan, L.AC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.

Verify at the official NPI Registry.