Individual provider Active NPI

Leny Virginia Bolivar, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1073801494
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P80972 Issued in NY
Practice address
1841 Park Ave
3E
New York, NY 10035-1316
Phone
(646) 559-6674
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P80972 NY Primary

Addresses

Primary practice location

1841 Park Ave
3E
New York, NY 10035-1316

Mailing address

1841 Park Ave
3E
New York, NY 10035-1316
Phone (646) 559-6674

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
P80972NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1073801494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "address_2": "3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-559-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "address_2": "3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-559-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "LENY",
        "middle_name": "VIRGINIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P80972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.