Individual provider Active NPI

Alexa Taveras-Gomez, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1215553169
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097361 Issued in NY
Practice address
28 Debevoise St Ste 5
Brooklyn, NY 11206-4194
Phone
(718) 963-4430
Fax
(646) 398-2794
NPI assigned
Jun 16, 2020
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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 111020 NY
Clinical Social Worker 1041C0700X 097361 NY Primary
School Social Worker 1041S0200X

Addresses

Primary practice location

28 Debevoise St Ste 5
Brooklyn, NY 11206-4194

Mailing address

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

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
111020NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1215553169",
    "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": "112064194",
            "telephone_number": "718-963-4430",
            "fax_number": "646-398-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS-GOMEZ",
        "first_name": "ALEXA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "111020",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097361",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 6, 2025; 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.