Individual provider Active NPI

Tiffany Duong-Rodriguez, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1013497643
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106757-01 Issued in NY
Practice address
14 Wall St FL 20
New York, NY 10005-2123
Phone
(862) 800-5584
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 84702 CA
Clinical Social Worker 1041C0700X 106757-01 NY Primary

Addresses

Primary practice location

14 Wall St FL 20
New York, NY 10005-2123

Mailing address

14 Wall St FL 20
New York, NY 10005-2123
Phone (862) 800-5584

Other practice location 1

515 Columbia Ave Ste 200
Los Angeles, CA 90017-1209
Phone (213) 249-9388

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

LicenseStateTypeSpecialty
106757-01NYMDClinical Social Worker
84702CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1013497643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WALL ST FL 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052123",
            "telephone_number": "862-800-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WALL ST FL 20",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052123",
            "telephone_number": "862-800-5584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Columbia Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171209",
            "country_code": "US",
            "telephone_number": "213-249-9388",
            "fax_number": "213-389-7993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG-RODRIGUEZ",
        "first_name": "TIFFANY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "84702",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "106757-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.