Individual provider Active NPI

Johanna Climenko, LCSW, ADTR, LCAT

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1285856914
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R055841 Issued in NY
Practice address
120 Riverside Dr
Suite 2W
New York, NY 10024-3709
Phone
(212) 874-3475
Fax
(212) 924-6567
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R055841 NY Primary

Addresses

Primary practice location

120 Riverside Dr
Suite 2W
New York, NY 10024-3709

Mailing address

345 8TH Ave
Apartment 16H
New York, NY 10001-4828
Phone (212) 989-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R055841NYMDClinical Social Worker
055841NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285856914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 8TH AVE",
            "address_2": "APARTMENT 16H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014828",
            "telephone_number": "212-989-4949",
            "fax_number": "212-924-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RIVERSIDE DR",
            "address_2": "SUITE 2W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243709",
            "telephone_number": "212-874-3475",
            "fax_number": "212-924-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIMENKO",
        "first_name": "JOHANNA",
        "name_prefix": "Ms.",
        "credential": "LCSW, ADTR, LCAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R055841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.