Individual provider Active NPI

Betsy Vasquez

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1174284111
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1841 Park Ave
New York, NY 10035-1316
Phone
(646) 459-6156
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 108986 NY
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1841 Park Ave
New York, NY 10035-1316

Mailing address

1289 Neill Ave # 2
Bronx, NY 10461-1733
Phone (646) 549-7442

Other practice location 1

3708 91st St Ste 3A
Jackson Heights, NY 11372-7962
Phone (718) 779-2263

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
108986NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Providers of Western Queens PastSince Jan 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1174284111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 NEILL AVE # 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611733",
            "telephone_number": "646-549-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351316",
            "telephone_number": "646-459-6156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3708 91st St Ste 3A",
            "address_purpose": "LOCATION",
            "city": "Jackson Heights",
            "state": "NY",
            "postal_code": "113727962",
            "country_code": "US",
            "telephone_number": "718-779-2263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "BETSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "108986",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.