Individual provider Active NPI

Juana Elvira Trejo-Reyes

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1174868624
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075708-1 Issued in NY
Practice address
2445 Arthur Ave
Bronx, NY 10458-6003
Phone
(917) 575-5844
NPI assigned
Dec 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075708-1 NY Primary

Addresses

Primary practice location

2445 Arthur Ave
Bronx, NY 10458-6003

Mailing address

244 5TH Ave # J284
New York, NY 10001-7604
Phone (347) 514-9196

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
075708-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gardenia Counseling Services, LCSW, PLLC Clinical CurrentSince Aug 28, 2022 Accepting new patients

Locations

244 5th Ave
#J284
New York, NY 10001
Phone (347) 514-9196

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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1174868624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 5TH AVE # J284",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017604",
            "telephone_number": "347-514-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 ARTHUR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104586003",
            "telephone_number": "917-575-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJO-REYES",
        "first_name": "JUANA",
        "middle_name": "ELVIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075708-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 24, 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.