Juliette Rose Lackow, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

104208 Issued in NY

Practice address

171 Madison Ave RM 1005
New York, NY 10016-5110

Phone

(646) 731-9828

NPI assigned

Jun 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Center for Personal Growth & Wellness LLC

  dba CPGW

  • Psychologist
  • New York, NY
  • NPI 1851732713
  NPD (past)

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1780360867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 25TH AVE APT B",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902916309",
            "telephone_number": "973-820-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MADISON AVE RM 1005",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165110",
            "telephone_number": "646-731-9828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "352 7th Ave Rm 801",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100015655",
            "country_code": "US",
            "telephone_number": "646-418-1172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKOW",
        "first_name": "JULIETTE",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "120018",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "104208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judyta Otylia Lacka, MS
• Bryan Lackey, PMHNP-BC
• Roy S Lackey, MD
• Michael Joesph Lackner, P.A.
• Jacob Lackow, M.A.
• Rachel Stephanie Lacks, ED.M.
• Noah Laclair
• Jessica B Lacorte, AUD
• Kenny Mikita Lacossiere, NURSE PRACTITIONER
• Nicole Lacoste, RPA-C

• 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 Sep 23, 2026; 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.