John Ibiam, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103937 Issued in NY

Practice address

1110 South Ave Ste 404
Staten Island, NY 10314-3411

Phone

(800) 277-4680

Fax

(888) 556-9797

NPI assigned

Sep 5, 2011

Last updated

Aug 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1982985933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10902 169TH PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114332932",
            "telephone_number": "718-570-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SOUTH AVE STE 404",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143411",
            "telephone_number": "800-277-4680",
            "fax_number": "888-556-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBIAM",
        "first_name": "JOHN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-05",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Rose Ianni, CCC-SLP
• Taylor Marie Iannicelli, PA-C
• Louis Nicholas Iannuzzi, PT
• Maira Ibarra Cruz
• Benedette Eyiuche Ibenegbu, NURSE PRACTITIONER
• Aneesa Ible, LCSW
• Manzila Ibragimova
• Parvina Ibragimova, FNP
• Dina Ibrahim
• Jineen Ibrahim

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, 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 Aug 20, 2026; 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.