Individual provider Active NPI

Alexandra A Wilkosz, LCSW

  • Clinical Social Worker
  • Fairport, NY
National Provider Identifier
1306295704
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082487 Issued in NY
Practice address
1387 Fairport Rd
Suite 1000D
Fairport, NY 14450-2003
Phone
(585) 641-0281
Fax
(585) 641-0286
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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 082487 NY Primary

Addresses

Primary practice location

1387 Fairport Rd
Suite 1000D
Fairport, NY 14450-2003

Mailing address

1387 Fairport Road
Suite 1000D
Fairport, NY 14450
Phone (585) 641-0281

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
082487NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1306295704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT ROAD",
            "address_2": "SUITE 1000D",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "14450",
            "telephone_number": "585-641-0281",
            "fax_number": "585-641-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "SUITE 1000D",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-641-0281",
            "fax_number": "585-641-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKOSZ",
        "first_name": "ALEXANDRA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.