Theo Czerevko, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088154 Issued in NY

Practice address

26 Court St Ste 709
Brooklyn, NY 11242-1107

Phone

(484) 362-9373

NPI assigned

May 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1164959078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROSPECT PARK SW APT 3G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155948",
            "telephone_number": "484-362-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 709",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421107",
            "telephone_number": "484-362-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZEREVKO",
        "first_name": "THEO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Leigh Cyrus, PT, DPT
• Chenee Cytall-Leslie, NURSE PRACTITIONER
• Chana A Cytryn
• Israel Cywiak, OTR/L
• Krystina Czaja, PT
• Charles Czermak, SWI
• Megan Elizabeth Czerniak, DPT
• Luiza Aleksandra Czerniawski, DO
• Yolanda Czerwinska, RPH
• Esther Czin

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 Oct 4, 2023; 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.