Individual provider Active NPI

Yessenia Scarlett Rodriguez-Moscol, LCSW

  • Clinical Social Worker
  • Flushing, NY
National Provider Identifier
1073058350
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090802 Issued in NY
Practice address
14015 Sanford Ave Ste B
Flushing, NY 11355-2688
Phone
(917) 502-2088
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 090802 NY Primary

Addresses

Primary practice location

14015 Sanford Ave Ste B
Flushing, NY 11355-2688

Mailing address

14015 Sanford Ave Ste B
Flushing, NY 11355-2688
Phone (917) 502-2088

Other practice location 1

3410 108th St
Corona, NY 11368-1222
Phone (347) 287-0175

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
I20210308001443 NY Practitioner - Clinical Social Worker 1759797210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Center of Ny, Inc. CurrentSince Jan 27, 2021 Accepting new patients

Locations

14015 Sanford Ave
Ste B
Flushing, NY 11355
Phone (718) 450-9242

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1073058350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14015 SANFORD AVE STE B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552688",
            "telephone_number": "917-502-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015 SANFORD AVE STE B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552688",
            "telephone_number": "917-502-2088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3410 108th St",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "NY",
            "postal_code": "113681222",
            "country_code": "US",
            "telephone_number": "347-287-0175",
            "fax_number": "347-287-0172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-MOSCOL",
        "first_name": "YESSENIA",
        "middle_name": "SCARLETT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.