Nicholas Kardaras, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73-072649 Issued in NY

Practice address

53480 Main Road Route 25
Suite 1
Southold, NY 11971

Phone

(347) 528-8108

NPI assigned

Sep 27, 2010

Last updated

Sep 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Omega Recovery

  • Substance Abuse Rehabilitation Facility
  • Austin, TX
  • NPI 1699268466
  NPD (past) Authorized official

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1255640132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PEQUASH AVE",
            "address_2": "PO BOX 226",
            "city": "CUTCHOGUE",
            "state": "NY",
            "postal_code": "119351447",
            "telephone_number": "347-528-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53480 MAIN ROAD ROUTE 25",
            "address_2": "SUITE 1",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "11971",
            "telephone_number": "347-528-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDARAS",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73-072649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Imperato, LMT
• Infinite Possiblities Therapy
• Janet Jackowski
• Jelaine Physical Therapy, PLLC
• Peter Kevin Johnstone Jr., MSPT
• Harriette Keely, RN
• Noreen Bawn Kelly, PT
• Casey Kerbs, RDN, CDN
• Jeanne Kiernan, SLP
• Irene Kontoleon

• Clinical Social Worker in Southold, NY
• Providers in Southold, 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 Sep 27, 2010; 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.