Individual provider Active NPI

Victoria Joy Hagemann, LCSWR

  • Clinical Social Worker
  • East Williston, NY
National Provider Identifier
1912051053
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R057842 1 Issued in NY
Practice address
11 Hight Street
East Williston, NY 11596
Phone
(516) 384-0967
NPI assigned
Jan 23, 2007
Last updated
Apr 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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 R057842 1 NY Primary

Addresses

Primary practice location

11 Hight Street
East Williston, NY 11596

Mailing address

548 Oxford St
Westbury, NY 11590-2429
Phone (516) 384-0967

Other identifiers 1

IdentifierTypeStateIssuer
R0578421OtherNYEDUCATION DEP OFFICE OF P

Other names 1

  • Miss Victoria Joy Hagemann Professional name

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
R057842 1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1912051053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 OXFORD ST",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115902429",
            "telephone_number": "516-384-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HIGHT STREET",
            "city": "EAST WILLISTON",
            "state": "NY",
            "postal_code": "11596",
            "telephone_number": "516-384-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMANN",
        "first_name": "VICTORIA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R057842 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATION DEP OFFICE OF P",
            "identifier": "R0578421",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "HAGEMANN",
            "middle_name": "JOY",
            "prefix": "MISS",
            "credential": "LCSWR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Williston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.