Individual provider Active NPI

Yenia J Randall, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1215163977
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0721651 Issued in NY
Practice address
28 Debevoise St Ste 5
Brooklyn, NY 11206
Phone
(718) 963-4430
Fax
(718) 963-0814
NPI assigned
Jun 8, 2009
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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 0721651 NY Primary

Addresses

Primary practice location

28 Debevoise St Ste 5
Brooklyn, NY 11206

Mailing address

145 W 15TH St FL 2
New York, NY 10011-6701
Phone (212) 924-6320

Other practice location 1

10 Hanover Pl
P.H.
Brooklyn, NY 11201-5840
Phone (718) 222-1518 ext. 11

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0721651NYMDClinical Social Worker
072165NYMDMedical license number

Practice roles

OrganizationSpecialtyStatusNew patients
Spanish Speaking Ederly Council-Raices Clinical Past Accepting new patients
Catholic Charities Neigborhood Services Clinical Past Accepting new patients
Spanish Speaking Elderly Council- Raices Clinical Past Accepting new patients
Federation Employment and Guidance Service, Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1215163977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 15TH ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116701",
            "telephone_number": "212-924-6320",
            "fax_number": "646-306-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 DEBEVOISE ST STE 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-4430",
            "fax_number": "718-963-0814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Hanover Pl",
            "address_2": "P.H.",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112015840",
            "country_code": "US",
            "telephone_number": "718-222-1518 x11",
            "fax_number": "718-222-4376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "YENIA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0721651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.