Individual provider Active NPI

Joey B Ackerman, LCSW-R

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1982860334
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R078965 Issued in NY
Practice address
231 Front St
Suite 113
Brooklyn, NY 11201-1217
Phone
(917) 559-0735
Fax
(718) 559-4805
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R078965 NY
Mental Health Counselor 101YM0800X R078965 NY Primary

Addresses

Primary practice location

231 Front St
Suite 113
Brooklyn, NY 11201-1217

Mailing address

231 Front St
Suite 113
Brooklyn, NY 11201-1217
Phone (917) 559-0735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 21, 2024 through Feb 21, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R078965NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tete Dumbo LCSW Clinical CurrentSince Aug 6, 2019 Accepting new patients

Locations

68 Jay St
Ste 409
Brooklyn, NY 11201
Phone (646) 477-4912

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": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1982860334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 FRONT ST",
            "address_2": "SUITE 113",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011217",
            "telephone_number": "917-559-0735",
            "fax_number": "718-559-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 FRONT ST",
            "address_2": "SUITE 113",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011217",
            "telephone_number": "917-559-0735",
            "fax_number": "718-559-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "JOEY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R078965",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R078965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.