Individual provider Active NPI

Joanna Komoska, LCSW

  • Clinical Social Worker
  • Southampton, NY
National Provider Identifier
1528298510
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO26527-1 Issued in NY
Practice address
355 Sebonac Rd
Southampton, NY 11968-2720
Phone
(631) 283-3981
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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 RO26527-1 NY Primary

Addresses

Primary practice location

355 Sebonac Rd
Southampton, NY 11968-2720

Mailing address

355 Sebonac Rd
Southampton, NY 11968-2720
Phone (631) 283-3981

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

LicenseStateTypeSpecialty
RO26527-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1528298510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 SEBONAC RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119682720",
            "telephone_number": "631-283-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 SEBONAC RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119682720",
            "telephone_number": "631-283-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOSKA",
        "first_name": "JOANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO26527-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.