Nazanin Adriana Kavoussi, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084192 Issued in NY

Practice address

119 W 124TH St
New York, NY 10027-4920

Phone

(917) 386-1798

NPI assigned

Feb 16, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brave Medical PCGroup PAC ID 2567882731, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nazanin.kavoussi.1@23300.direct.athenahealth.com

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

• Brave Medical P.C.

  • Community/Behavioral Health Agency
  • Yonkers, NY
  • NPI 1902415318
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1306186044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920",
            "telephone_number": "917-386-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 124TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274920",
            "telephone_number": "917-386-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVOUSSI",
        "first_name": "NAZANIN",
        "middle_name": "ADRIANA",
        "name_prefix": "Ms.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-16",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "28134",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Kavish, LMHC
• Kavita Sharma MD PLLC
• Richard S Kavner, O.D.
• Rose F Kavo, LCSW
• Kyriaki Kavourias, PA
• Rebecca Julia Kavoussi, LCSW
• Hymavati Kavuri
• Fnu Kavya Mohandas
• Kristine Kaw, NP-C
• Lay H Kaw, PHARM.D.

• Clinical Social Worker in New York, NY
• Providers in New York, 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 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.