Individual provider Active NPI

Teresa Vassallo, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1174853741
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082756 Issued in NY
Practice address
2527 Glebe Ave
Bronx, NY 10461-3109
Phone
(718) 904-4400
Fax
(718) 931-7307
NPI assigned
Jan 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 079640-1 NY
Clinical Social Worker 1041C0700X 082756 NY Primary

Addresses

Primary practice location

2527 Glebe Ave
Bronx, NY 10461-3109

Mailing address

2527 Glebe Ave
Bronx, NY 10461-3109
Phone (718) 904-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816000540 NY Practitioner - Clinical Social Worker 3375926926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079640-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 23, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Apr 23, 2022 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2527 Glebe Ave
Bronx, NY 10461
Phone (718) 904-4400

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1174853741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 GLEBE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613109",
            "telephone_number": "718-904-4400",
            "fax_number": "718-931-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 GLEBE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613109",
            "telephone_number": "718-904-4400",
            "fax_number": "718-931-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079640-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.