Individual provider Active NPI

Doris Wilamowski, LCSW

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1184383770
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
016094 Issued in NY
Practice address
10420 Queens Blvd Apt 22a
Forest Hills, NY 11375-3613
Phone
(212) 730-0303
NPI assigned
Dec 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X PR16094 NY
Clinical Social Worker 1041C0700X 016094 NY Primary

Addresses

Primary practice location

10420 Queens Blvd Apt 22a
Forest Hills, NY 11375-3613

Mailing address

10420 Queens Blvd Apt 22a
Forest Hills, NY 11375-3613
Phone (212) 730-0303

Other identifiers 1

IdentifierTypeStateIssuer
5317OtherINSURANCE PRIVATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PR16094NYMDGroup Psychotherapy Psychologist
016094NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1184383770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 QUEENS BLVD APT 22A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753613",
            "telephone_number": "212-730-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 QUEENS BLVD APT 22A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753613",
            "telephone_number": "212-730-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILAMOWSKI",
        "first_name": "DORIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-11",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "PR16094",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "016094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE PRIVATE",
            "identifier": "5317",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.