Individual provider Active NPI

Jamie Fastov, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1083527659
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
133171 Issued in NY
Practice address
125 E 23Rd St Ste 304
New York, NY 10010-4576
Phone
(212) 906-9038
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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 44SL07556900 NJ
Social Worker 104100000X 133171 NY Primary

Addresses

Primary practice location

125 E 23Rd St Ste 304
New York, NY 10010-4576

Mailing address

77 Park Ave Apt 315
Hoboken, NJ 07030-7107
Phone (917) 446-1062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1083527659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 PARK AVE APT 315",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070307107",
            "telephone_number": "917-446-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E 23RD ST STE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104576",
            "telephone_number": "212-906-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASTOV",
        "first_name": "JAMIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL07556900",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "133171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.