Laura Mary Sophocleous, LCSW, LMFT, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084597-1 Issued in NY

Practice address

10-45 Nameoke Street
Far Rockaway, NY 11691

Phone

(718) 327-3723

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912092396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10-45 NAMEOKE STREET",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-327-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10-45 NAMEOKE STREET",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-327-3723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2146 JACKSON AVE",
            "address_purpose": "LOCATION",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "11783",
            "country_code": "US",
            "telephone_number": "516-221-3030",
            "fax_number": "516-221-4160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2146 JACKSON AVE",
            "address_purpose": "LOCATION",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "11783",
            "country_code": "US",
            "telephone_number": "516-221-3030",
            "fax_number": "516-221-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOPHOCLEOUS",
        "first_name": "LAURA",
        "middle_name": "MARY",
        "credential": "LCSW, LMFT, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084597-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.