Active NPI
Steven Dennis Poburko, LCSW-R
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1851424022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 047601-1
- Practice address
- 3312 Surf Ave
Brooklyn, NY 11224-1406 - Phone
- (718) 449-4000
- Fax
- (718) 449-5146
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- 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 | 047601-1 | NY | Primary |
Addresses
Primary practice location
3312 Surf Ave
Brooklyn, NY 11224-1406
Mailing address
749 Union St
Apt. 4L
Brooklyn, NY 11215-1240
Phone (718) 230-5023
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 |
|---|---|---|---|
| 047601-1 | NY | MD | Clinical Social Worker |
| 073186 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851424022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 UNION ST",
"address_2": "APT. 4L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112151240",
"telephone_number": "718-230-5023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3312 SURF AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112241406",
"telephone_number": "718-449-4000",
"fax_number": "718-449-5146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POBURKO",
"first_name": "STEVEN",
"middle_name": "DENNIS",
"credential": "LCSW-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "047601-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.