Active NPI
Ilene V Fishman, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1396112264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R031669-1
- Practice address
- 445 W 23Rd St
#1E
New York, NY 10011-1444 - Phone
- (212) 255-2074
- NPI assigned
- Aug 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R031669-1 | NY | Primary |
| Clinical Social Worker | 1041C0700X | SC07509 | NJ |
Addresses
Primary practice location
445 W 23Rd St
#1E
New York, NY 10011-1444
Mailing address
445 W 23Rd St
#1E
New York, NY 10011-1444
Phone (212) 255-2074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC07509 | NJ | MD | Clinical Social Worker |
| R031669-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1396112264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 W 23RD ST",
"address_2": "#1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111444",
"telephone_number": "212-255-2074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 W 23RD ST",
"address_2": "#1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100111444",
"telephone_number": "212-255-2074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHMAN",
"first_name": "ILENE",
"middle_name": "V",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-27",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R031669-1",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "SC07509",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.