Individual provider Active NPI

Linda A Wilk, LCSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1336303320
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075928-1 Issued in NY
Practice address
9 Willard Way
Dix Hills, NY 11746-7826
Phone
(631) 252-3588
NPI assigned
Jul 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075928-1 NY Primary
Clinical Social Worker 1041C0700X 080522-1 NY

Addresses

Primary practice location

9 Willard Way
Dix Hills, NY 11746-7826

Mailing address

9 Willard Way
Dix Hills, NY 11746-7826
Phone (631) 252-3588

Other identifiers 2

IdentifierTypeStateIssuer
080522-1OtherNYNYS OFFICE OF THE PROFESSIONS
075928-1OtherNYSTATE LIC.

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130520000179 NY Practitioner - Clinical Social Worker 7618114265 Practice locations: Dix Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Willard Way
Dix Hills, NY 11746-7826
Phone (631) 385-7867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075928-1NYMDClinical Social Worker
080522-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1336303320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WILLARD WAY",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467826",
            "telephone_number": "631-252-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 WILLARD WAY",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467826",
            "telephone_number": "631-252-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILK",
        "first_name": "LINDA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075928-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080522-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OFFICE OF THE PROFESSIONS",
            "identifier": "080522-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC.",
            "identifier": "075928-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.