Confidential LCSW Services,P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084662 Issued in NY

Legal business name

CONFIDENTIAL LCSW SERVICES,P.C.

Practice address

3047 Brighton 14TH St
2ND Floor
Brooklyn, NY 11235-5501

Phone

(917) 544-5473

NPI assigned

Apr 25, 2017

Organization subpart

No

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

Authorized official

Name

Tatyana Shahova, LCSWNPI 1033429188

Title

President

Phone

(917) 544-5473

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tatyana Shahova

  • Social Worker
  • Brooklyn, NY
  • NPI 1033429188
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1235664491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3047 BRIGHTON 14TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355501",
            "telephone_number": "917-544-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 BRIGHTON 14TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355501",
            "telephone_number": "917-544-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFIDENTIAL LCSW SERVICES,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "SHAHOVA",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-544-5473",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.