Individual provider Active NPI

Izabelle Reyhanian Hakim, LCSW

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1205149689
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074405 Issued in NY
Practice address
13 Locust Dr
Great Neck, NY 11021-1724
Phone
(516) 472-0453
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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 074405 NY Primary

Addresses

Primary practice location

13 Locust Dr
Great Neck, NY 11021-1724

Mailing address

13 Locust Dr
Great Neck, NY 11021-1724
Phone (516) 472-0453

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
I20110322000394 NY Practitioner - Clinical Social Worker 9133302680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Guidance Counseling & Licensed Clinical Social Work Services PC Clinical CurrentSince Oct 15, 2018 Accepting new patients
Ageless Mind Ny Inc CurrentSince Oct 16, 2019 Accepting new patients

Locations

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1205149689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 LOCUST DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211724",
            "telephone_number": "516-472-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 LOCUST DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211724",
            "telephone_number": "516-472-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "IZABELLE",
        "middle_name": "REYHANIAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.