KJG LCSW, PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73079357 Issued in NY

Legal business name

KJG LCSW, PC

Practice address

1844 E 12TH St
Brooklyn, NY 11229-2702

Phone

(917) 618-2379

NPI assigned

May 23, 2018

Organization subpart

No

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

Authorized official

Name

Michelle Yetta Cordero, LCSW-R

Title

President

Phone

(917) 618-2379

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1184115388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292702",
            "telephone_number": "917-618-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 E 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292702",
            "telephone_number": "917-618-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJG LCSW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "CORDERO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "YETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-618-2379",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73079357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hiroshi Kiyota, RPT
• Jayasree Kizhakkepat Pisharam, MD
• Sofiya Kizhner, LMSW
• Michelle Kizhnerman
• Saul Kizon
• KJMC Certified Home Health Agency
• Dana Klager
• Mordechai Klagsbrun
• Esther Klahr
• Kristin Klahr, PH.D.

• 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 May 23, 2018; 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.