Individual provider Active NPI

Lily Hetzler

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1619604428
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
120355-01 Issued in NY
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

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 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

LicenseStateTypeSpecialty
120355-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Contemporary Psychotherapy Multi-Specialty PastSince Jan 14, 2024 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.

Verify at the official NPI Registry.