Organization Active NPI

Live a Life by Design LCSW PLLC

  • Clinical Social Worker
  • Scarsdale, NY
National Provider Identifier
1366717936
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078494 Issued in NY
Legal business name
LIVE A LIFE BY DESIGN LCSW PLLC
Practice address
455 Central Park Ave
Suite 311
Scarsdale, NY 10583-1060
Phone
(914) 589-3588
NPI assigned
Mar 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Staci Rosenberg, SW
Title
Owner
Phone
(914) 589-3588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 078494 NY Primary

Addresses

Primary practice location

455 Central Park Ave
Suite 311
Scarsdale, NY 10583-1060

Mailing address

455 Central Park Ave
Suite 311
Scarsdale, NY 10583-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120425000032 NY Part B Supplier - Clinic/Group Practice 0648432419 Receives reassigned benefits from 1 practitioner
Practice locations: Scarsdale, NY
O20230516001320 FL Part B Supplier - Clinic/Group Practice 0648432419 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

455 Central Park Ave
Ste 206
Scarsdale, NY 10583
Phone (914) 309-0933

455 Central Park Ave
Ste 311
Scarsdale, NY 10583
Phone (914) 574-5390

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1366717936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 CENTRAL PARK AVE",
            "address_2": "SUITE 311",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 CENTRAL PARK AVE",
            "address_2": "SUITE 311",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831060",
            "telephone_number": "914-589-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE A LIFE BY DESIGN LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "STACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-589-3588",
        "authorized_official_credential": "SW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.