Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Octavio Roman, LCSW-R

Individual provider Clinical Social Worker · NPI 1215055512

Mr. Octavio Roman, LCSW-R is a Clinical Social Worker in Brooklyn, New York. Qualified in 1982, 44 years ago. Practices with St Vincent's Services Inc, a 6-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
44
Licensed in
NY
In the registry since
2007
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Practice location Address checks out

333 Atlantic Ave
Brooklyn, NY 11201-5803
Phone: (718) 522-6011
Fax: (718) 522-1560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R028922 (NY)

Record details

NPI number1215055512
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW-R
Sole proprietorNo
NPI enumeratedMarch 26, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1982 (44 years in practice)
Group practice St. Vincent'S Services Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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