Active NPI
Tanya Grace-Ereka Avery, LMSW
- Social Worker
- Elmhurst, NY
National Provider Identifier
1053076711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 72083263
- Practice address
- 9131 Queens Blvd
Elmhurst, NY 11373-5555 - Phone
- (718) 896-3400
- NPI assigned
- Nov 7, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 72083263 | NY | Primary |
Addresses
Primary practice location
9131 Queens Blvd
Elmhurst, NY 11373-5555
Mailing address
22520 106TH Ave
Queens Village, NY 11429-2406
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 |
|---|---|---|---|
| 72083263 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636243200000",
"number": "1053076711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22520 106TH AVE",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114292406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9131 QUEENS BLVD",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735555",
"telephone_number": "718-896-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "TANYA",
"middle_name": "GRACE-EREKA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-07",
"last_updated": "2021-11-07",
"certification_date": "2021-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "72083263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.