NPIMap

Organization Active NPI

LCSW Evaluations and Clinical Social Work, P.C.

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1326331836
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R057074-1 Issued in NY
Legal business name
LCSW EVALUATIONS AND CLINICAL SOCIAL WORK, P.C.
Practice address
10 Flagship Cir
Staten Island, NY 10309-3979
Phone
(917) 636-2841
NPI assigned
May 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Authorized official

Name
Arkady Utkin, LCSWNPI 1205873015
Title
Director
Phone
(917) 836-2841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X R057074-1 NY Primary

Addresses

Primary practice location

10 Flagship Cir
Staten Island, NY 10309-3979

Mailing address

10 Flagship Cir
Staten Island, NY 10309-3979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110725000570 NY Part B Supplier - Clinic/Group Practice 9830367549 Receives reassigned benefits from 4 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1326331836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FLAGSHIP CIR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093979",
            "telephone_number": "917-636-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCSW EVALUATIONS AND CLINICAL SOCIAL WORK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "UTKIN",
        "authorized_official_first_name": "ARKADY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-836-2841",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R057074-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.