Individual provider Active NPI

Athena Motal, PHD, LCSW-R

  • Clinical Social Worker
  • Whitestone, NY
National Provider Identifier
1235519828
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R044975-1 Issued in NY
Practice address
15440 25TH Ave
Whitestone, NY 11357-3751
Phone
(347) 368-4758
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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 R044975-1 NY Primary

Addresses

Primary practice location

15440 25TH Ave
Whitestone, NY 11357-3751

Mailing address

15440 25TH Ave
Whitestone, NY 11357-3751
Phone (347) 368-4758

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
I20210506001143 NY Practitioner - Clinical Social Worker 9638588585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brooklyn Womens and Family Counseling Services LCSW PLLCGroup PAC ID 5496645921, 21 clinicians

Practice addresses (Care Compare)

7706 13TH Ave
Brooklyn, NY 11228-2414
Phone (718) 232-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R044975-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Womens & Family Counseling Services LCSW PLLC Clinical CurrentSince Mar 12, 2021 Accepting new patients

Locations

7706 13th Ave
Brooklyn, NY 11228
Phone (718) 879-8844

7706 13th Ave
Ste 2
Brooklyn, NY 11228
Phone (718) 313-4357

Organizations & group practices 1

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1235519828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15440 25TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573751",
            "telephone_number": "347-368-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15440 25TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573751",
            "telephone_number": "347-368-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTAL",
        "first_name": "ATHENA",
        "credential": "PHD, LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R044975-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

Verify at the official NPI Registry.