Individual provider Active NPI

Chastety Ivaniuk, LCSW, LMSW, CASAC

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1174988299
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06444100 Issued in NJ
Practice address
73 Lenox Ave
New York, NY 10026-3007
Phone
(212) 663-1596
NPI assigned
Dec 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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 44SC06444100 NJ Primary

Addresses

Primary practice location

73 Lenox Ave
New York, NY 10026-3007

Mailing address

773 Central Ave
Westfield, NJ 07090-2528
Phone (917) 601-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623000103 NY Order and Referring Only - Clinical Social Worker 5799297263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06444100NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1174988299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 CENTRAL AVE",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902528",
            "telephone_number": "917-601-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263007",
            "telephone_number": "212-663-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANIUK",
        "first_name": "CHASTETY",
        "credential": "LCSW, LMSW, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06444100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.