Individual provider Active NPI

Liat Justin, LCSW

  • Clinical Social Worker
  • Mount Kisco, NY
National Provider Identifier
1336697192
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088279 Issued in NY
Practice address
100 S Bedford Rd Ste 340
Mount Kisco, NY 10549-3444
Phone
(516) 647-9547
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 088279 NY Primary

Addresses

Primary practice location

100 S Bedford Rd Ste 340
Mount Kisco, NY 10549-3444

Mailing address

100 S Bedford Rd Ste 340
Mount Kisco, NY 10549-3444
Phone (516) 647-9547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1336697192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BEDFORD RD STE 340",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493444",
            "telephone_number": "516-647-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BEDFORD RD STE 340",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493444",
            "telephone_number": "516-647-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTIN",
        "first_name": "LIAT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.