Indigo Psychotherapy LCSW PC

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

Last updated

Oct 25, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Walaszek, LCSWNPI 1295277739

Title

Owner

Phone

(413) 537-6108

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca Walaszek, LCSW

  • Clinical Social Worker
  • New York, NY
  • NPI 1295277739
  Authorized official Same address or phone

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": []
}

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

• 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.