Active NPI
Danielle M Agtuca, CSW
- Clinical Social Worker
- Rockville Centre, NY
National Provider Identifier
1760656102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 076585
- Practice address
- 1000 N. Village Avenue
Rockville Centre, NY 11571 - Phone
- (516) 705-1353
- NPI assigned
- Apr 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 076585 | NY | Primary |
Addresses
Primary practice location
1000 N. Village Avenue
Rockville Centre, NY 11571
Mailing address
P.O. Box 798
Rockville Centre, NY 11571
Phone (516) 705-1353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076585 | Other | NY | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 076585 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1760656102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 798",
"city": "ROCKVILLE CENTRE",
"state": "NY",
"postal_code": "11571",
"telephone_number": "516-705-1353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N. VILLAGE AVENUE",
"city": "ROCKVILLE CENTRE",
"state": "NY",
"postal_code": "11571",
"telephone_number": "516-705-1353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGTUCA",
"first_name": "DANIELLE",
"middle_name": "M",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-16",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "076585",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "076585",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville Centre, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.