Individual provider Active NPI

Julie A. Rose, LCSW-R

  • Clinical Social Worker
  • Hicksville, NY
National Provider Identifier
1306044920
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R077326-1 Issued in NY
Practice address
400 S Oyster Bay Rd
Suite 208
Hicksville, NY 11801-3500
Phone
(516) 880-4831
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 642642051 NY
Clinical Social Worker 1041C0700X R077326-1 NY Primary

Addresses

Primary practice location

400 S Oyster Bay Rd
Suite 208
Hicksville, NY 11801-3500

Mailing address

400 S Oyster Bay Rd
Suite 208
Hicksville, NY 11801-3500
Phone (516) 880-4831

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R077326-1NYMDClinical Social Worker
642642051NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1306044920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD",
            "address_2": "SUITE 208",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-880-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD",
            "address_2": "SUITE 208",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-880-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JULIE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "642642051",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R077326-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.