Individual provider Active NPI

Laura L Novacek, LMSW, CASAC

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1780020834
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
078366-1 Issued in NY
Practice address
14 Slosson Ter
Staten Island, NY 10301-2507
Phone
(718) 273-8409
Fax
(718) 273-5265
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 078366-1 NY Primary

Addresses

Primary practice location

14 Slosson Ter
Staten Island, NY 10301-2507

Mailing address

40 Behan CT
Staten Island, NY 10306-2229
Phone (347) 661-7064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180511000530 NY Practitioner - Clinical Social Worker 4183988561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078366-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Project Hospitality, Inc. CurrentSince Apr 4, 2018 Accepting new patients
Project Hospitality Inc. Past Accepting new patients

Locations

14 Slosson Ter
Staten Island, NY 10301
Phone (718) 273-8409

100 Park Ave
Staten Island, NY 10302
Phone (718) 448-1544

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1780020834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BEHAN CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062229",
            "telephone_number": "347-661-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SLOSSON TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012507",
            "telephone_number": "718-273-8409",
            "fax_number": "718-273-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACEK",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "LMSW, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "078366-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.