Individual provider Active NPI

Alex Gerald Lazarich, LMSW

  • Social Worker
  • Queensbury, NY
National Provider Identifier
1710598479
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
25 Willowbrook Rd
Queensbury, NY 12804-5882
Phone
(518) 563-7100
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113933 NY
Social Worker 104100000X Primary

Addresses

Primary practice location

25 Willowbrook Rd
Queensbury, NY 12804-5882

Mailing address

25 Willowbrook Rd
Queensbury, NY 12804-5882
Phone (518) 563-7100

Other practice location 1

768 Delaware Ave
Buffalo, NY 14209-2006
Phone (716) 881-2405 ext. 2046

Other practice location 2

1000 Main St
Buffalo, NY 14202-1102
Phone (716) 881-2405

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
113933NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1710598479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-563-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-563-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "768 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142092006",
            "country_code": "US",
            "telephone_number": "716-881-2405 x2046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142021102",
            "country_code": "US",
            "telephone_number": "716-881-2405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZARICH",
        "first_name": "ALEX",
        "middle_name": "GERALD",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "113933",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.