Individual provider Active NPI

Victor Joseph Roger, LCSW

  • Clinical Social Worker
  • Valley Stream, NY
National Provider Identifier
1558435776
Registry record updated Nov 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076753-1 Issued in NY
Practice address
50 W Hawthorne Ave
Valley Stream, NY 11580-6220
Phone
(516) 569-6600
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2010

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 076753-1 NY Primary

Addresses

Primary practice location

50 W Hawthorne Ave
Valley Stream, NY 11580-6220

Mailing address

175 Fulton Ave
Hempstead, NY 11550-3718
Phone (516) 481-0052

Other identifiers 1

IdentifierTypeStateIssuer
00244817MedicaidNY

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
076753-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290297600000",
    "number": "1558435776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FULTON AVE",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115503718",
            "telephone_number": "516-481-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W HAWTHORNE AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806220",
            "telephone_number": "516-569-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGER",
        "first_name": "VICTOR",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2010-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076753-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244817",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2010; 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.