Richard Mark Africk, MSW
Individual provider Active NPI Clinical Social Worker · Staten Island, NY
NPI 1295876183 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295876183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 017528 (NY)
- Practice address
- 3 William Avenue
Staten Island, NY 10308 - Phone
- (718) 317-1482
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017528 | NY | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 017528 | NY | Yes |
Addresses
Primary practice location
3 William Avenue
Staten Island, NY 10308
Mailing address
668 Aldrich Road
Howell, NJ 07731
Phone (732) 850-5356
NPI Registry JSON
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295876183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "668 ALDRICH ROAD",
"city": "HOWELL",
"state": "NJ",
"postal_code": "07731",
"telephone_number": "732-850-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 WILLIAM AVENUE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10308",
"telephone_number": "718-317-1482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AFRICK",
"first_name": "RICHARD",
"middle_name": "MARK",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "017528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.