Ivelisse Concepcion, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084156 Issued in NY

Practice address

4123 3Rd Ave
Bronx, NY 10457-6222

Phone

(718) 299-3045

Fax

(718) 716-2605

NPI assigned

Nov 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1629408976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 15TH ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116701",
            "telephone_number": "718-299-3045",
            "fax_number": "718-716-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104576222",
            "telephone_number": "718-299-3045",
            "fax_number": "718-716-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "IVELISSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088515",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julienne Conaway
• Anny Patricia Concepcion
• Carmela Concepcion, MS ED.
• Elizabeth Concepcion, MD
• Ercilio Concepcion
• Joanne Concepcion
• Lydia Concepcion, MD
• Marie J Concepcion, M.S.
• Raquel Concepcion
• Sandra Concepcion, SI

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.