Individual provider Active NPI

Juliet Keeler-Lebien, LCSW-R

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1871724682
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076843-1 Issued in NY
Practice address
303 5TH Ave RM 1707
New York, NY 10016-6641
Phone
(917) 679-2023
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 107226 CA
Clinical Social Worker 1041C0700X 44SC06058900 NJ
Clinical Social Worker 1041C0700X 118628 MA
Clinical Social Worker 1041C0700X 5169C AL
Clinical Social Worker 1041C0700X 076843-1 NY Primary

Addresses

Primary practice location

303 5TH Ave RM 1707
New York, NY 10016-6641

Mailing address

14 Hawthorne Ave
Glen Ridge, NJ 07028-2011
Phone (917) 679-2023

Other practice location 1

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-5757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 3, 2022 through Oct 3, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5169CALMDClinical Social Worker
118628MAMDClinical Social Worker
44SC06058900NJMDClinical Social Worker
076843-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1871724682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HAWTHORNE AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070282011",
            "telephone_number": "917-679-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 5TH AVE RM 1707",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166641",
            "telephone_number": "917-679-2023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Beauvoir Ave",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013533",
            "country_code": "US",
            "telephone_number": "908-522-5757",
            "fax_number": "908-522-5779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEELER-LEBIEN",
        "first_name": "JULIET",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107226",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06058900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118628",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "5169C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076843-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.