Tanaeya Ashlei Renae Ervin, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

5752 Issued in CT

Practice address

554 Boston Post Rd
Orange, CT 06477-3341

Phone

(203) 489-2870

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Waterbury, CT
  • NPI 1841225489
  Medicare reassignment NPD
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1083370639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773341",
            "telephone_number": "203-489-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773341",
            "telephone_number": "203-489-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "TANAEYA",
        "middle_name": "ASHLEI RENAE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "5752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nataliia Dyatlova, MD
• Sarah Brixner Eisinger, LMFT
• Jacqueline Elise, APRN
• Emerald City Health Associates
• Eric Dwight English
• Katherine Esposito, SPEECH THERAPY
• Lauren Leigh Evanko I, PHARMD
• Evergreen Dental LLC
• Murielle Exantus, NP
• Exceldent Dental of Orange, LLP

• Social Worker in Orange, CT
• Providers in Orange, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.