Active NPI
Nina Klebanoff, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1942969571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R036028-1
- Practice address
- 185 Wend Ave 1J
New York, NY 10023 - Phone
- (929) 990-7190
- NPI assigned
- Dec 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R036028-1 | NY | Primary |
Addresses
Primary practice location
185 Wend Ave 1J
New York, NY 10023
Mailing address
140 Wend Ave
27B
New York, NY 10023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 28, 2016 through Jan 28, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R036028-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639353600000",
"number": "1942969571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 WEND AVE",
"address_2": "27B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 WEND AVE 1J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10023",
"telephone_number": "929-990-7190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEBANOFF",
"first_name": "NINA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-10",
"last_updated": "2021-12-13",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R036028-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.