Maria J Mendoza, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088773 Issued in NY

Practice address

6861 Yellowstone Blvd Ste 106a
Forest Hills, NY 11375-3313

Phone

(917) 604-6839

Fax

(516) 977-3542

NPI assigned

Mar 5, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1104451640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6861 YELLOWSTONE BLVD STE 106A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753313",
            "telephone_number": "917-604-6839",
            "fax_number": "516-977-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6861 YELLOWSTONE BLVD STE 106A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753313",
            "telephone_number": "917-604-6839",
            "fax_number": "516-977-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARIA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Julieth@verizon.net",
            "affiliation": "N",
            "address_1": "77 Princess St",
            "city": "Hicksville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "118011155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Memorial Sloan Kettering Cancer Center
• Orly Elinor Menasherov
• Mary Gertrude Menchaca
• Jeanette Mendez
• Gloria J Mendoza
• Qianya Meng, DDS
• Madeline Mensah
• Elba M Mera, RN
• Selena Mera
• Diana Mercado Vargas

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.