Individual provider Active NPI

Carmen Luz Vasquez-Rodriguez

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1114170842
Registry record updated Oct 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075082 Issued in NY
Practice address
1662 Ocean Ave
Brooklyn, NY 11230-4905
Phone
(917) 626-3169
Fax
(718) 677-4140
NPI assigned
Oct 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075082 NY Primary

Addresses

Primary practice location

1662 Ocean Ave
Brooklyn, NY 11230-4905

Mailing address

1662 Ocean Ave
Brooklyn, NY 11230-4905
Phone (917) 626-3169

Other names 1

  • Miss Carmen Luz Vasquez Other name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
075082NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1224979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224979200000",
    "number": "1114170842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304905",
            "telephone_number": "917-626-3169",
            "fax_number": "718-677-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304905",
            "telephone_number": "917-626-3169",
            "fax_number": "718-677-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ-RODRIGUEZ",
        "first_name": "CARMEN",
        "middle_name": "LUZ",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-26",
        "last_updated": "2008-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "VASQUEZ",
            "middle_name": "LUZ",
            "prefix": "MISS",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2008; 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.