Individual provider Active NPI

Emerita Rita Verdejo, LCSW, CCFP, IIC

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1215451828
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06088500 Issued in NJ
Practice address
710 West 168TH Street
Suite 1402
New York, NY 10032
Phone
(347) 698-1199
NPI assigned
Jul 26, 2017
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 100499-1 NY
Clinical Social Worker 1041C0700X 094623 NY
Clinical Social Worker 1041C0700X 44SC06088500 NJ Primary

Addresses

Primary practice location

710 West 168TH Street
Suite 1402
New York, NY 10032

Mailing address

25 W Central Ave # 1029
Bergenfield, NJ 07621-1301
Phone (347) 698-1199

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
100499-1NYMDSocial Worker
44SC06088500NJMDClinical Social Worker
094623NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Healing & Social Justice Clinical Current Accepting new patients
Aldea Counseling Services LCSW PC Clinical PastSince Mar 31, 2013 Accepting new patients

Organizations & group practices 2

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": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1215451828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W CENTRAL AVE # 1029",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211301",
            "telephone_number": "347-698-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 WEST 168TH STREET",
            "address_2": "SUITE 1402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "347-698-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDEJO",
        "first_name": "EMERITA",
        "middle_name": "RITA",
        "name_prefix": "Ms.",
        "credential": "LCSW, CCFP, IIC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2023-02-13",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "100499-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094623",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06088500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.