Individual provider Active NPI

Kathy Fixman Laska I, CSW

  • Clinical Social Worker
  • Chappaqua, NY
National Provider Identifier
1902978042
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24817R Issued in NY
Practice address
465 Bedford Road
Chappaqua, NY 10514
Phone
(914) 238-3509
Fax
(914) 238-1716
NPI assigned
Nov 14, 2006
Last updated
Mar 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24817R NY Primary

Addresses

Primary practice location

465 Bedford Road
Chappaqua, NY 10514

Mailing address

465 Bedford Road
Chappaqua, NY 10514
Phone (914) 238-3509

Other identifiers 1

IdentifierTypeStateIssuer
11236777OtherNYCAQH STANDARD CREDENTIALI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000135 NY Practitioner - Clinical Social Worker 8426174400 Practice locations: Chappaqua, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

465 Bedford Rd
Chappaqua, NY 10514-2209
Phone (914) 238-3509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24817RNYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1902978042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 BEDFORD ROAD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "10514",
            "telephone_number": "914-238-3509",
            "fax_number": "914-238-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 BEDFORD ROAD",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "10514",
            "telephone_number": "914-238-3509",
            "fax_number": "914-238-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKA",
        "first_name": "KATHY",
        "middle_name": "FIXMAN",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "24817R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH STANDARD CREDENTIALI",
            "identifier": "11236777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chappaqua, NY

Sources for this page

Verify at the official NPI Registry.