Individual provider Active NPI

Rachel Y Moheban, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1477673390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
053994 Issued in NY
Practice address
77 Bleecker St
Apt. 513
New York, NY 10012-1547
Phone
(917) 273-8836
NPI assigned
Apr 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 053994 NY Primary

Addresses

Primary practice location

77 Bleecker St
Apt. 513
New York, NY 10012-1547

Mailing address

77 Bleecker St
Apt. 513
New York, NY 10012-1547
Phone (917) 273-8836

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
053994NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477673390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BLEECKER ST",
            "address_2": "APT. 513",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121547",
            "telephone_number": "917-273-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BLEECKER ST",
            "address_2": "APT. 513",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121547",
            "telephone_number": "917-273-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHEBAN",
        "first_name": "RACHEL",
        "middle_name": "Y",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "053994",
            "primary": true
        }
    ],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.