Individual provider Active NPI

Cruz Yolande Fuksman, LMSW

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1720319114
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
072549 Issued in NY
Practice address
2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone
(718) 235-3100
Fax
(718) 277-0822
NPI assigned
Jan 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 072549 NY Primary

Addresses

Primary practice location

2857 Linden Blvd
Brooklyn, NY 11208-5126

Mailing address

176 Sunnyside Ave
Brooklyn, NY 11207-2111
Phone (718) 751-5758

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
072549NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center PastSince Dec 19, 2009 Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

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": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1720319114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 SUNNYSIDE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072111",
            "telephone_number": "718-751-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085126",
            "telephone_number": "718-235-3100",
            "fax_number": "718-277-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKSMAN",
        "first_name": "CRUZ",
        "middle_name": "YOLANDE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "072549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.