Individual provider Active NPI

Sofia Vaksman, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1962058180
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081657 Issued in NY
Practice address
1684 E 18TH St
Brooklyn, NY 11229-1249
Phone
(917) 669-2359
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 081657 NY Primary

Addresses

Primary practice location

1684 E 18TH St
Brooklyn, NY 11229-1249

Mailing address

180 Stonegate Dr
Staten Island, NY 10304-4444
Phone (917) 669-2359

Other practice location 1

180 Stonegate Dr
Staten Island, NY 10304-4444
Phone (917) 669-2359

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
I20191014000067 NY Practitioner - Clinical Social Worker 7618208208 Reassigns benefits to 1 organization
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Psychiatric Care PCGroup PAC ID 4486669595, 2 clinicians

Practice addresses (Care Compare)

2493 Richmond Rd
Suite 2
Staten Island, NY 10306-1936
Phone (718) 238-2285

345 82ND St
Brooklyn, NY 11209-3808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081657NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Care PC CurrentSince Jan 1, 2020 Accepting new patients

Locations

2493 Richmond Rd
Ste 2
Staten Island, NY 10306
Phone (718) 238-2285

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1962058180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 STONEGATE DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044444",
            "telephone_number": "917-669-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 E 18TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291249",
            "telephone_number": "917-669-2359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Stonegate Dr",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103044444",
            "country_code": "US",
            "telephone_number": "917-669-2359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAKSMAN",
        "first_name": "SOFIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.