Active NPI
Iliana Baez, LMSW
- Mental Health Counselor
- Bronx, NY
National Provider Identifier
1134533193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 092951
- Practice address
- 1419 Shakespeare Ave
Bronx, NY 10452-1851 - Phone
- (718) 732-7080
- Fax
- (718) 732-7090
- NPI assigned
- Jun 18, 2014
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 092951 | NY | Primary |
Addresses
Primary practice location
1419 Shakespeare Ave
Bronx, NY 10452-1851
Mailing address
3410 Kingsbridge Ave
Bronx, NY 10463-4022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141397918 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 092951 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423699200000",
"number": "1134533193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 KINGSBRIDGE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104634022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1419 SHAKESPEARE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104521851",
"telephone_number": "718-732-7080",
"fax_number": "718-732-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEZ",
"first_name": "ILIANA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-18",
"last_updated": "2015-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "092951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "141397918",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.