Individual provider Active NPI

Jason La, LMSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1215354220
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088465 Issued in NY
Practice address
123-125 West. 124TH St.
New York, NY 10027
Phone
(212) 531-1300
Fax
(212) 531-1085
NPI assigned
Mar 27, 2014
Last updated
Mar 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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 088465 NY Primary

Addresses

Primary practice location

123-125 West. 124TH St.
New York, NY 10027

Mailing address

1722 Linden St
Apt. 2L
Ridgewood, NY 11385-2146
Phone (917) 981-5904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088465NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Mar 23, 2019 Accepting new patients
Sun River Health Inc CurrentSince Mar 23, 2019 Accepting new patients
Upper Room AIDS Ministry, Inc. Adult Day Health Care Center. Clinical PastSince Jan 4, 2016 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1215354220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 LINDEN ST",
            "address_2": "APT. 2L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852146",
            "telephone_number": "917-981-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123-125 WEST. 124TH ST.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10027",
            "telephone_number": "212-531-1300",
            "fax_number": "212-531-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA",
        "first_name": "JASON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.