Individual provider Active NPI

Ivana De Lucia

  • Social Worker
  • Roslyn Heights, NY
National Provider Identifier
1558124164
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
122793 Issued in NY
Practice address
200 S Service Rd
Roslyn Heights, NY 11577-2126
Phone
(917) 526-0766
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 122793 NY
Adult Mental Health Clinic/Center 261QM0850X 122793 NY
Adolescent and Children Mental Health Clinic/Center 261QM0855X 122793 NY
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 122793 NY Primary

Addresses

Primary practice location

200 S Service Rd
Roslyn Heights, NY 11577-2126

Mailing address

135 Mill Spring Rd
Manhasset, NY 11030-3608

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
122793NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1558124164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MILL SPRING RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S SERVICE RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772126",
            "telephone_number": "917-526-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LUCIA",
        "first_name": "IVANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "122793",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "122793",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NY",
            "license": "122793",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "122793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.