Active NPI
Lily Hetzler
- Social Worker
- Brooklyn, NY
National Provider Identifier
1619604428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 120355-01
- Practice address
- 117 Dobbin St Ste 210
Brooklyn, NY 11222-2803 - Phone
- (646) 881-0305
- NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | 120355-01 | NY | Primary |
Addresses
Primary practice location
117 Dobbin St Ste 210
Brooklyn, NY 11222-2803
Mailing address
117 Dobbin St Ste 210
Brooklyn, NY 11222-2803
Phone (929) 399-7115
Other practice location 1
4115 50th St Apt 3G
Woodside, NY 11377-4311
Phone (929) 399-7115
Other practice location 2
33 W 60th St Fl 4
New York, NY 10023-7905
Phone (212) 333-3444
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
| License | State | Type | Specialty |
|---|---|---|---|
| 120355-01 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Contemporary Psychotherapy | Multi-Specialty | Past | Accepting new patients |
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": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1619604428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 DOBBIN ST STE 210",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112222803",
"telephone_number": "929-399-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 DOBBIN ST STE 210",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112222803",
"telephone_number": "646-881-0305"
}
],
"practiceLocations": [
{
"address_1": "4115 50th St Apt 3G",
"address_purpose": "LOCATION",
"city": "Woodside",
"state": "NY",
"postal_code": "113774311",
"country_code": "US",
"telephone_number": "929-399-7115",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "33 W 60th St Fl 4",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100237905",
"country_code": "US",
"telephone_number": "212-333-3444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HETZLER",
"first_name": "LILY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "120355-01",
"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 Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.