Individual provider Active NPI

Raymond Rodriguez, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1508031436
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077444-1
Practice address
161 W 54TH St Apt 602
New York, NY 10019
Phone
(917) 822-3036
NPI assigned
Apr 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 066767-1 NY
Clinical Social Worker 1041C0700X 077444-1 Primary

Addresses

Primary practice location

161 W 54TH St Apt 602
New York, NY 10019

Mailing address

161 W 54TH St Apt 602
New York, NY 10019-5318
Phone (917) 822-3036

Other practice location 1

4322 50th St
Suite 2C
Woodside, NY 11377-4442
Phone (917) 822-3036

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: No
  • 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

State licenses

LicenseStateTypeSpecialty
077444NYMDSocial Worker
066767-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aldea Counseling Services LCSW PC Clinical CurrentSince Mar 31, 2013 Accepting new patients

Locations

601 W 150th St
New York, NY 10031
Phone (212) 491-2910

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1508031436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 W 54TH ST APT 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195318",
            "telephone_number": "917-822-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 W 54TH ST APT 602",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "917-822-3036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4322 50th St",
            "address_2": "Suite 2C",
            "address_purpose": "LOCATION",
            "city": "Woodside",
            "state": "NY",
            "postal_code": "113774442",
            "country_code": "US",
            "telephone_number": "917-822-3036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "066767-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "077444-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.