LCSW Interventions for Emotional Growth, PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

RO46222 Issued in NY

Legal business name

LCSW INTERVENTIONS FOR EMOTIONAL GROWTH, PC

Practice address

14101 68TH Dr
Suite a
Kew Gardens Hills, NY 11367-1635

Phone

(718) 520-0798

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Monica Brignolo, LCSWNPI 1255342309

Title

Clinical Director

Phone

(718) 520-0798

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monica V Brignolo, LCSW

  • Clinical Social Worker
  • Kew Gardens Hills, NY
  • NPI 1255342309
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1114286101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 68TH DR",
            "address_2": "SUITE A",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671635",
            "telephone_number": "718-520-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 68TH DR",
            "address_2": "SUITE A",
            "city": "KEW GARDENS HILLS",
            "state": "NY",
            "postal_code": "113671635",
            "telephone_number": "718-520-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCSW INTERVENTIONS FOR EMOTIONAL GROWTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "BRIGNOLO",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "718-520-0798",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO46222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "9865705",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH UNIVERSAL CREDENTIALS",
            "identifier": "11699877",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PIN",
            "identifier": "274655",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02864693",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS/ FAMILY HEALTH PLUS/ CHILD HEALTH PLUS",
            "identifier": "000600019133",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Clara Hirsch, MS, PT
• Lingsum Hsucheng, PT, DPT
• Stephen Jue
• Brianna Simone Kelly, MS
• Rochelle Khanimov
• Jack M. Levine, M.D.
• Emily Lorber
• Asha Mampilly, OTR/L
• Molly T McMahon, MSED
• Rachel Lynn Mendoza, OTR

• Clinical Social Worker in Kew Gardens Hills, NY
• Providers in Kew Gardens Hills, 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 May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.