Organization Active NPI

Kokoro Wellness LCSW PC

  • Clinical Social Worker
  • Rockville Centre, NY
National Provider Identifier
1124864319
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KOKORO WELLNESS LCSW PC
Practice address
78 N Village Ave
Rockville Centre, NY 11570-4606
Phone
(914) 400-7535
Fax
(516) 502-0544
NPI assigned
Jul 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Luke Unneland, LCSWNPI 1487252615
Title
Owner
Phone
(914) 400-7535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

78 N Village Ave
Rockville Centre, NY 11570-4606

Mailing address

4 New St
Pleasantville, NY 10570-3107
Phone (914) 400-7535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240923000339 NY Part B Supplier - Clinic/Group Practice 4880135599 Receives reassigned benefits from 1 practitioner
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

78 N Village Ave
Rockville Centre, NY 11570
Phone (914) 400-7535

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1124864319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NEW ST",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105703107",
            "telephone_number": "914-400-7535",
            "fax_number": "516-502-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704606",
            "telephone_number": "914-400-7535",
            "fax_number": "516-502-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKORO WELLNESS LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A",
        "authorized_official_last_name": "UNNELAND",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-400-7535",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.