Luis Antonio Velasquez, SOCIAL WORKER

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

119408-01 Issued in NY

Practice address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Phone

(315) 772-9519

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1740046846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22465 DUFFY RD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011766",
            "telephone_number": "315-767-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "LUIS",
        "middle_name": "ANTONIO",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "119408-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Valencia, BCBA
• Elizabeth Vanslyke, PHARMD
• Igor Vasilj, PH.D.
• Mary Carmen Vazquez, LCSW
• Lauren Veccia-Smith, PA
• Diondre Lamar Venable, DDS
• Sara Vescoli
• Nancy E Viele, RPH
• Jamie Voelker, DMD
• Mark Robert Voelker, DMD

• Clinical Social Worker in Fort Drum, NY
• Providers in Fort Drum, 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 Feb 26, 2024; 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.