Individual provider Active NPI

Eva Hernandez-Goley, LCSW

  • Clinical Social Worker
  • West Nyack, NY
National Provider Identifier
1033508445
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083247-1 Issued in NY
Practice address
719 W Nyack Rd
West Nyack, NY 10994-2240
Phone
(917) 428-6177
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 079883-1 NY
Clinical Social Worker 1041C0700X 083247-1 NY Primary

Addresses

Primary practice location

719 W Nyack Rd
West Nyack, NY 10994-2240

Mailing address

719 W Nyack Rd
Ste 43
West Nyack, NY 10994-2241
Phone (917) 428-6177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421000597 NY Practitioner - Clinical Social Worker 4486952645 Reassigns benefits to 1 organization
Practice locations: West Nyack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

719 W Nyack Rd
West Nyack, NY 10994-2240
Phone (917) 428-6177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083247NYMDSocial Worker
079883-1NYMDClinical Social Worker
083247-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
VCS Inc. CurrentSince Aug 20, 2020 Accepting new patients
West Nyack Pharmacy LLC CurrentSince Oct 19, 2020 Accepting new patients
Clarkstown Pharmacy Inc PastSince Oct 19, 2020 Accepting new patients

Locations

77 S Main St
New City, NY 10956
Phone (845) 634-5729

719 W Nyack Rd
West Nyack, NY 10994
Phone (845) 358-3588

Interoperability endpoints

  • Direct secure messaging: eva.hernandezgoley@rck.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1033508445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W NYACK RD",
            "address_2": "STE 43",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942241",
            "telephone_number": "917-428-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W NYACK RD",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942240",
            "telephone_number": "917-428-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-GOLEY",
        "first_name": "EVA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079883-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083247-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

Verify at the official NPI Registry.