Individual provider Active NPI

Patricia Ann Iovine, LCSW, CASAC

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1114163854
Registry record updated Dec 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076036-1 Issued in NY
Practice address
1492 Richmond Rd
Suite 2
Staten Island, NY 10304-2319
Phone
(917) 658-1245
NPI assigned
Dec 31, 2008
Last updated
Dec 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11469 NY
Clinical Social Worker 1041C0700X 076036-1 NY Primary

Addresses

Primary practice location

1492 Richmond Rd
Suite 2
Staten Island, NY 10304-2319

Mailing address

15 Windemere Ave Apt 1a
Staten Island, NY 10306-2080
Phone (917) 658-1245

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: Yes
  • 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
11469NYMDAddiction (Substance Use Disorder) Counselor
076036-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1114163854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WINDEMERE AVE APT 1A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062080",
            "telephone_number": "917-658-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 RICHMOND RD",
            "address_2": "SUITE 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042319",
            "telephone_number": "917-658-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOVINE",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11469",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076036-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.