Individual provider Active NPI

Josephine Ovalles, LCSW-R

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1962661348
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080267 Issued in NY
Practice address
5 Debevoise St
Ste 1
Brooklyn, NY 11206-4069
Phone
(347) 529-8108
Fax
(718) 904-9648
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 083992 NY
Clinical Social Worker 1041C0700X 080267 NY Primary

Addresses

Primary practice location

5 Debevoise St
Ste 1
Brooklyn, NY 11206-4069

Mailing address

PO Box 370479
Brooklyn, NY 11237-0479
Phone (347) 529-8108

Other identifiers 2

IdentifierTypeStateIssuer
03823338MedicaidNY
104100000XMedicaidNY

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
I20130410000342 NY Practitioner - Clinical Social Worker 4587800966 Practice locations: Bronx, NY; Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083992NYMDSocial Worker
080267NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Ann Schreuder, LCSW PC Clinical PastSince Jan 15, 2018 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1962661348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370479",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112370479",
            "telephone_number": "347-529-8108",
            "fax_number": "718-904-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DEBEVOISE ST",
            "address_2": "STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064069",
            "telephone_number": "347-529-8108",
            "fax_number": "718-904-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVALLES",
        "first_name": "JOSEPHINE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "083992",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03823338",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104100000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.