Active NPI
Rachel Christine Perezic, LCSW, CASAC-MC
- Clinical Social Worker
- New York, NY
National Provider Identifier
1316500044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 092580
- Practice address
- 462 1St Ave
New York, NY 10016 - Phone
- (212) 562-4594
- NPI assigned
- Apr 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23340 | NY | |
| Clinical Social Worker | 1041C0700X | 092580 | NY | Primary |
Addresses
Primary practice location
462 1St Ave
New York, NY 10016
Mailing address
462 1St Ave
New York, NY 10016-9196
Other practice location 1
462 1st Ave
New York, NY 10016
Phone (212) 562-4594
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220615000947 | NY | Order and Referring Only - Clinical Social Worker | 0446639850 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23340 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 092580 | NY | MD | Clinical Social Worker |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1316500044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-562-4594"
}
],
"practiceLocations": [
{
"address_1": "462 1st Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10016",
"country_code": "US",
"telephone_number": "212-562-4594",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZIC",
"first_name": "RACHEL",
"middle_name": "CHRISTINE",
"name_prefix": "Ms.",
"credential": "LCSW, CASAC-MC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-18",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "23340",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "092580",
"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 Apr 8, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.