Active NPI
Matti Ilmari Kala, LMSW
- Social Worker
- Queens Village, NY
National Provider Identifier
1003070665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 074105-1
- Practice address
- 22005 Jamaica Ave
Queens Village, NY 11428-2140 - Phone
- (718) 740-5000
- Fax
- (718) 479-0200
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 074105-1 | NY | Primary |
Addresses
Primary practice location
22005 Jamaica Ave
Queens Village, NY 11428-2140
Mailing address
7001 113TH St
Apt. 7F
Forest Hills, NY 11375-4656
Phone (718) 793-0304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074105-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1003070665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001 113TH ST",
"address_2": "APT. 7F",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754656",
"telephone_number": "718-793-0304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22005 JAMAICA AVE",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114282140",
"telephone_number": "718-740-5000",
"fax_number": "718-479-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALA",
"first_name": "MATTI",
"middle_name": "ILMARI",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "074105-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.