Individual provider Active NPI

Jessica Gangapersaud, LMSW

  • Clinical Social Worker
  • Forest Hills, NY
National Provider Identifier
1194433094
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118049 Issued in NY
Practice address
11020 71St Rd Ste 111
Forest Hills, NY 11375-4975
Phone
(718) 793-3133
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 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 118049 NY Primary

Addresses

Primary practice location

11020 71St Rd Ste 111
Forest Hills, NY 11375-4975

Mailing address

9330 123Rd St
South Richmond Hill, NY 11419-1427
Phone (347) 571-1915

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
118049NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1194433094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 123RD ST",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191427",
            "telephone_number": "347-571-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 71ST RD STE 111",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754975",
            "telephone_number": "718-793-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGAPERSAUD",
        "first_name": "JESSICA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "118049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.