MEDICARE: MRS. JAMES VIVIENNE NAICKER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	094576-01	NY
2	104100000X	Social Worker	106888	NY

General Provider Information

NPI Number	:	1548814593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JAMES VIVIENNE NAICKER LCSW

Provider Business Mailing Address
First Line	:	333 86TH ST APT 2H
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 86TH ST APT 2H
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5053
Country	:	US
Telephone Number	:	352-494-8109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	06/13/2026

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