Nicole Sisti, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089958 Issued in NY

Practice address

1868 Bleecker St Apt 1L
Flushing, NY 11385-1347

Phone

(315) 761-8388

NPI assigned

Oct 9, 2020

Last updated

Jan 12, 2021By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Self Therapy LCSW, PLLC

  • Mental Health Counselor
  • Flushing, NY
  • NPI 1922998855
  NPD Authorized official

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1790383032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 BLEECKER ST APT 1L",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113851347",
            "telephone_number": "315-761-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 BLEECKER ST APT 1L",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113851347",
            "telephone_number": "315-761-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTI",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "08995801",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Sionov
• Ravi Vamsi Siriki, MD
• Camille Josephine Sirotnikov, MD
• Rosalynn H. Sirya, MD
• Narciso Sison, PT
• Divya Situt, M.D.
• Diane M Sixsmith, MD
• SJK Adult Daycare Center Inc
• Sjkny Acupuncture PC (Asian Hoistic Center)
• Nicolas Skafidas, MA OTR/L

• Clinical Social Worker in Flushing, NY
• Providers in Flushing, 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 Jan 12, 2021; 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.