Individual provider Active NPI

Justin Donofrio, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1669920534
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084439-1 Issued in NY
Practice address
928 Broadway, Ste 400
New York, NY 10010-3055
Phone
(646) 820-0603
NPI assigned
Sep 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 084439-1 NY Primary

Addresses

Primary practice location

928 Broadway, Ste 400
New York, NY 10010-3055

Mailing address

347 W 55TH St Apt 4H
New York, NY 10019-4516
Phone (347) 256-3996

Other practice location 1

448 W 57th St
Garden Suite
New York, NY 10019-3055
Phone (646) 820-0603

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
084439-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1669920534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 W 55TH ST APT 4H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100194516",
            "telephone_number": "347-256-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY, STE 400",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103055",
            "telephone_number": "646-820-0603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "448 W 57th St",
            "address_2": "Garden Suite",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100193055",
            "country_code": "US",
            "telephone_number": "646-820-0603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOFRIO",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-20",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084439-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.