Individual provider Active NPI

Joanne Konecky, LCSW

  • Clinical Social Worker
  • Roslyn Heights, NY
National Provider Identifier
1881953719
Registry record updated Sep 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088654 Issued in NY
Practice address
49 Red Ground Rd
Roslyn Heights, NY 11577-1710
Phone
(516) 978-9197
NPI assigned
May 12, 2012
Last updated
Sep 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 034002-1 NY
Clinical Social Worker 1041C0700X 088654 NY Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

49 Red Ground Rd
Roslyn Heights, NY 11577-1710

Mailing address

49 Red Ground Rd
Roslyn Heights, NY 11577-1710
Phone (516) 978-9197

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
034002-1NYMDSocial Worker
088654NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1336780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567900800000",
    "number": "1881953719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 RED GROUND RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771710",
            "telephone_number": "516-978-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 RED GROUND RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771710",
            "telephone_number": "516-978-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONECKY",
        "first_name": "JOANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-12",
        "last_updated": "2019-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "034002-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088654",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; 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.