Organization Active NPI

Indigo Psychotherapy LCSW PC

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1730656992
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INDIGO PSYCHOTHERAPY LCSW PC
Practice address
330 W 58TH St Ste 409
New York, NY 10019-1820
Phone
(413) 537-6108
NPI assigned
Oct 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Rebecca Walaszek, LCSW
Title
Owner
Phone
(413) 537-6108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

330 W 58TH St Ste 409
New York, NY 10019-1820

Mailing address

25 Woodbine St Apt 3R
Brooklyn, NY 11221-5586
Phone (413) 537-6108

Other practice location 1

117 Dobbin St Ste 208
Brooklyn, NY 11222-2803
Phone (646) 378-3816

National Provider Directory

National Provider Directory

Locations

117 Dobbin St
Ste 208
Brooklyn, NY 11222
Phone (646) 378-3816

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1730656992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WOODBINE ST APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112215586",
            "telephone_number": "413-537-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 409",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191820",
            "telephone_number": "413-537-6108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Dobbin St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112222803",
            "country_code": "US",
            "telephone_number": "646-378-3816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INDIGO PSYCHOTHERAPY LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "WALASZEK",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-537-6108",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 25, 2018; 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.