Karen Luckmann, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

084295 Issued in NY

Practice address

3375 Park Ave
Suite 2005
Wantagh, NY 11793-3733

Phone

(516) 781-1911

Fax

(516) 781-1173

NPI assigned

Aug 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Karen Defalco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1720336993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "address_2": "SUITE 2005",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-781-1911",
            "fax_number": "516-781-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "address_2": "SUITE 2005",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-781-1911",
            "fax_number": "516-781-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKMANN",
        "first_name": "KAREN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03003069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "DEFALCO",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.