Individual provider Active NPI

Tarra M. Neblett, LMSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1073774469
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075180-1 Issued in NY
Practice address
16318 Jamaica Ave
6TH Floor
Jamaica, NY 11432-4901
Phone
(718) 206-3440
Fax
(718) 205-3638
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075180-1 NY Primary

Addresses

Primary practice location

16318 Jamaica Ave
6TH Floor
Jamaica, NY 11432-4901

Mailing address

19011 Nashville Blvd
Springfield Gardens, NY 11413-1024
Phone (718) 978-7295

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
075180-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1073774469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19011 NASHVILLE BLVD",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114131024",
            "telephone_number": "718-978-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16318 JAMAICA AVE",
            "address_2": "6TH FLOOR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324901",
            "telephone_number": "718-206-3440",
            "fax_number": "718-205-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBLETT",
        "first_name": "TARRA",
        "middle_name": "M.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075180-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.