Active NPI
Calla Jo, LMSW
- Social Worker
- Forest Hills, NY
National Provider Identifier
1083861124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 062752
- Practice address
- 110-20 71 Road
111
Forest Hills, NY 11375 - Phone
- (718) 793-3133
- Fax
- (718) 793-2023
- NPI assigned
- Aug 20, 2008
- 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 | 062752 | NY | Primary |
Addresses
Primary practice location
110-20 71 Road
111
Forest Hills, NY 11375
Mailing address
110-20 71 Road
111
Forest Hills, NY 11375
Phone (718) 793-3133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00244826 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 062752 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219190400000",
"number": "1083861124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110-20 71 ROAD",
"address_2": "111",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-793-3133",
"fax_number": "718-793-2023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110-20 71 ROAD",
"address_2": "111",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-793-3133",
"fax_number": "718-793-2023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JO",
"first_name": "CALLA",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2008-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "062752",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00244826",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.