Individual provider Active NPI

Milena Georgieva-Kazakov, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1215090063
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R072570 Issued in NY
Practice address
177 Prince St
Apt 504
New York, NY 10012-2935
Phone
(212) 706-7559
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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 R072570 NY Primary

Addresses

Primary practice location

177 Prince St
Apt 504
New York, NY 10012-2935

Mailing address

65 W 90TH St
19E
New York, NY 10024-1504
Phone (212) 706-7559

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
I20120119000220 NY Practitioner - Clinical Social Worker 7315114105 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

177 Prince St
Apt 504
New York, NY 10012-2935
Phone (212) 706-7559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R072570NYMDClinical Social Worker
072570NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1215090063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W 90TH ST",
            "address_2": "19E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100241504",
            "telephone_number": "212-706-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 PRINCE ST",
            "address_2": "APT 504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122935",
            "telephone_number": "212-706-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIEVA-KAZAKOV",
        "first_name": "MILENA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R072570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.