Organization Active NPI

Izabelle Hakim LCSW PLLC

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1184265860
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
IZABELLE HAKIM LCSW PLLC
Practice address
55 Northern Blvd Ste 406
Great Neck, NY 11021-4058
Phone
(516) 726-0301
NPI assigned
Oct 3, 2019
Last updated
Oct 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Ms. Izabelle Reyhanian Hakim, LCSWNPI 1205149689
Title
Owner
Phone
(516) 726-0301

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 Worker 1041C0700X Primary

Addresses

Primary practice location

55 Northern Blvd Ste 406
Great Neck, NY 11021-4058

Mailing address

55 Northern Blvd Ste 406
Great Neck, NY 11021-4058
Phone (516) 726-0301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191217002219 NY Part B Supplier - Clinic/Group Practice 1850725235 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Locations

55 Northern Blvd
Ste 406
Great Neck, NY 11021
Phone (516) 726-0301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1184265860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NORTHERN BLVD STE 406",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214058",
            "telephone_number": "516-726-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NORTHERN BLVD STE 406",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214058",
            "telephone_number": "516-726-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IZABELLE HAKIM LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "HAKIM",
        "authorized_official_first_name": "IZABELLE",
        "authorized_official_middle_name": "REYHANIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-726-0301",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.