Irene P Korolczuk, LCSW R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO36795 Issued in NY

Practice address

29 Northgate Dr
Greenlawn, NY 11740-2312

Phone

(631) 271-0913

Fax

(631) 261-3250

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Irene P Korolczuk Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1104963982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NORTHGATE DR",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117402312",
            "telephone_number": "631-271-0913",
            "fax_number": "631-271-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NORTHGATE DR",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117402312",
            "telephone_number": "631-271-0913",
            "fax_number": "631-261-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLCZUK",
        "first_name": "IRENE",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "LCSW R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO36795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENE",
            "last_name": "KOROLCZUK",
            "middle_name": "P",
            "prefix": "MRS.",
            "credential": "LCSW-R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cathryn W Karafa, LSP
• Kristen Kelly, PA-C
• Anne E. Kieran, D.O.
• Kimberly Crocco Inc.
• Paul Korman, RPH
• Suzanne Krishnamoorthy, DO
• Kelly A Kuntz, LPN
• Pascale Gloria Lafortune, MD
• Melissa Kimberly Lapierre
• Paul Lasinski

• Clinical Social Worker in Greenlawn, NY
• Providers in Greenlawn, 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 Sep 16, 2022; 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.