Individual provider Active NPI

Deloria Berks, LCSW, CASACT

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1063644409
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08449-1 Issued in NY
Practice address
41 E 11TH St # 51
Suite 40
New York, NY 10003-4602
Phone
(646) 494-3134
NPI assigned
Aug 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23033 NY
Clinical Social Worker 1041C0700X 08449-1 NY Primary

Addresses

Primary practice location

41 E 11TH St # 51
Suite 40
New York, NY 10003-4602

Mailing address

41 E 11TH St # 51
Suite 40
New York, NY 10003-4602
Phone (646) 494-3134

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
23033NYMDAddiction (Substance Use Disorder) Counselor
08449-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: deloriaberks@tdh.allscriptsdirect.net

Organizations & group practices 1

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": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1063644409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E 11TH ST # 51",
            "address_2": "SUITE 40",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034602",
            "telephone_number": "646-494-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 11TH ST # 51",
            "address_2": "SUITE 40",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034602",
            "telephone_number": "646-494-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKS",
        "first_name": "DELORIA",
        "credential": "LCSW, CASACT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "23033",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "08449-1",
            "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 Apr 10, 2013; 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.