Avantgarde Behavioral Health Services LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

077151 Issued in NY

Legal business name

AVANTGARDE BEHAVIORAL HEALTH SERVICES LCSW PLLC

Practice address

19 W 34TH St
New York, NY 10001-3006

Phone

(917) 291-2191

Fax

(718) 332-2273

NPI assigned

Feb 27, 2013

Last updated

Feb 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ludmilla Rubinov, LCSWNPI 1487737169

Title

Vice President/Owner

Phone

(917) 291-2191

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ludmilla Rubinov, LCSW

  • Clinical Social Worker
  • New York, NY
  • NPI 1487737169
  NPD (past) Authorized official

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1083954077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HASTINGS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353017",
            "telephone_number": "917-291-2191",
            "fax_number": "718-332-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013006",
            "telephone_number": "917-291-2191",
            "fax_number": "718-332-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTGARDE BEHAVIORAL HEALTH SERVICES LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "RUBINOV",
        "authorized_official_first_name": "LUDMILLA",
        "authorized_official_title_or_position": "VICE PRESIDENT/OWNER",
        "authorized_official_telephone_number": "917-291-2191",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487737169",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A400042543",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00077151",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in New York, NY
• Providers in New York, 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 Feb 27, 2013; 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.