Individual provider Active NPI

William Desiena, LCSW

  • Clinical Social Worker
  • West Nyack, NY
National Provider Identifier
1114411121
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091833 Issued in NY
Practice address
719 W Nyack Rd
West Nyack, NY 10994-2240
Phone
(917) 681-4270
NPI assigned
Jun 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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 091833 NY Primary

Addresses

Primary practice location

719 W Nyack Rd
West Nyack, NY 10994-2240

Mailing address

719 W Nyack Rd Ste 43
West Nyack, NY 10994-2241
Phone (917) 681-4270

Other practice location 1

77 S Main St
New City, NY 10956-3511
Phone (845) 634-5729 ext. 332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 12, 2024 through Jun 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091833NYMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
VCS Inc. PastSince Aug 3, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1114411121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W NYACK RD STE 43",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942241",
            "telephone_number": "917-681-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W NYACK RD",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942240",
            "telephone_number": "917-681-4270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 S Main St",
            "address_purpose": "LOCATION",
            "city": "New City",
            "state": "NY",
            "postal_code": "109563511",
            "country_code": "US",
            "telephone_number": "845-634-5729 x332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESIENA",
        "first_name": "WILLIAM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.