Active NPI
Paula Anexagorou, LCSW
- Early Intervention Provider Agency
- Forest Hills, NY
National Provider Identifier
1215445614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 7000 Austin St.
Forest Hills, NY 11375-1022 - Phone
- (718) 762-7633
- NPI assigned
- Jan 19, 2018
- Reactivated
- Mar 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 086344 | NY | |
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
7000 Austin St.
Forest Hills, NY 11375-1022
Mailing address
7000 Austin St.
Forest Hills, NY 11375-1022
Phone (718) 762-7633
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
| License | State | Type | Specialty |
|---|---|---|---|
| 086344 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553817600000",
"number": "1215445614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7000 AUSTIN ST.",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751022",
"telephone_number": "718-762-7633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 AUSTIN ST.",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751022",
"telephone_number": "718-762-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANEXAGOROU",
"first_name": "PAULA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2019-03-29",
"deactivation_date": "2019-03-05",
"reactivation_date": "2019-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "086344",
"primary": false
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"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 Mar 29, 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.