Active NPI
Roxanne Wolanczyk, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1093082075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 082455
- Practice address
- 504 Grand St Apt B61
B61
New York, NY 10002-4147 - Phone
- (917) 209-2168
- NPI assigned
- Nov 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 082455 | NY | Primary |
Addresses
Primary practice location
504 Grand St Apt B61
B61
New York, NY 10002-4147
Mailing address
504 Grand Street
B61
New York, NY 10002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082455 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413331200000",
"number": "1093082075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 GRAND STREET",
"address_2": "B61",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 GRAND ST APT B61",
"address_2": "B61",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100024147",
"telephone_number": "917-209-2168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLANCZYK",
"first_name": "ROXANNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-19",
"last_updated": "2014-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "082455",
"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 Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.