Individual provider Active NPI

Lucielle Miriam Roman, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1649930363
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100574 Issued in NY
Practice address
2527 Glebe Ave
Bronx, NY 10461-3109
Phone
(718) 904-4400
NPI assigned
Dec 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 100574 NY Primary
Social Worker 104100000X 114337 NY

Addresses

Primary practice location

2527 Glebe Ave
Bronx, NY 10461-3109

Mailing address

18 Dickinson Ave
Nyack, NY 10960-2917
Phone (347) 313-9101

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
I20260311002199 NY Practitioner - Clinical Social Worker 9638652365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114337NYMDSocial Worker
100574NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Feb 1, 2026 Accepting new patients

Locations

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

31 W Broad St
Fl 3
Haverstraw, NY 10927
Phone (845) 429-4499

Organizations & group practices 2

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": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1649930363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 DICKINSON AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602917",
            "telephone_number": "347-313-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 GLEBE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613109",
            "telephone_number": "718-904-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "LUCIELLE",
        "middle_name": "MIRIAM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100574",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "114337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.