Individual provider Active NPI

Vicki Breitbart, LCSW

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1336897933
Registry record updated Mar 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PR024106-1 Issued in NY
Practice address
558 10TH St
Brooklyn, NY 11215-4402
Phone
(347) 267-6339
NPI assigned
Mar 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PR024106-1 NY Primary

Addresses

Primary practice location

558 10TH St
Brooklyn, NY 11215-4402

Mailing address

558 10TH St
Brooklyn, NY 11215-4402
Phone (347) 267-6339

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
I20260506000121 NY Practitioner - Clinical Social Worker 5799253027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

484 1St St
Brooklyn, NY 11215-2606

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR024106-1NYMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647129600000",
    "number": "1336897933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 10TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154402",
            "telephone_number": "347-267-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 10TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154402",
            "telephone_number": "347-267-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITBART",
        "first_name": "VICKI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-13",
        "last_updated": "2022-03-13",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "PR024106-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.