Individual provider Active NPI

Aryeh L Wiederkehr, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1588978555
Registry record updated Jan 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081506 Issued in NY
Practice address
2020 Coney Island Ave
Brooklyn, NY 11223-2329
Phone
(718) 676-4210
NPI assigned
Aug 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 081610 NY
Clinical Social Worker 1041C0700X 081506 NY Primary

Addresses

Primary practice location

2020 Coney Island Ave
Brooklyn, NY 11223-2329

Mailing address

14732 69TH Rd # 11367
Flushing, NY 11367-1732
Phone (347) 730-3286

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
081610NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452384000000",
    "number": "1588978555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14732 69TH RD # 11367",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671732",
            "telephone_number": "347-730-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232329",
            "telephone_number": "718-676-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERKEHR",
        "first_name": "ARYEH",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2016-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081610",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2016; 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.