Individual provider Active NPI

Emil Zakutny, D.S.W.

  • Clinical Social Worker
  • Baldwin, NY
National Provider Identifier
1639109531
Registry record updated May 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R029350 Issued in NY
Practice address
865 Merrick Rd Ste 305
Baldwin, NY 11510-3338
Phone
(516) 868-3421
Fax
(516) 623-3644
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R029350 NY Primary
Marriage & Family Therapist 106H00000X 000547-1 NY
Addiction (Substance Use Disorder) Counselor 101YA0400X 5284 NY

Addresses

Primary practice location

865 Merrick Rd Ste 305
Baldwin, NY 11510-3338

Mailing address

460 Old Country Rd
Garden City, NY 11530-1852
Phone (516) 868-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090622000115 NY Practitioner - Clinical Social Worker 9133270713 Practice locations: Carle Place, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

256 Wright Ave
Carle Place, NY 11514-2018
Phone (516) 712-8463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5284NYMDAddiction (Substance Use Disorder) Counselor
R029350NYMDClinical Social Worker
000547-1NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Psychological Consultants, LLP 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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241913600000",
    "number": "1639109531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OLD COUNTRY RD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301852",
            "telephone_number": "516-868-3421",
            "fax_number": "516-623-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 MERRICK RD STE 305",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103338",
            "telephone_number": "516-868-3421",
            "fax_number": "516-623-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKUTNY",
        "first_name": "EMIL",
        "name_prefix": "Dr.",
        "credential": "D.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R029350",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000547-1",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "5284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

Verify at the official NPI Registry.