Individual provider Active NPI

Deset Tilahun Seyoum

  • Social Worker
  • Nanuet, NY
National Provider Identifier
1265101695
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
7 Jeanne Marie GDNS Apt I
Nanuet, NY 10954-1916
Phone
(845) 598-1315
NPI assigned
Sep 9, 2021
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

7 Jeanne Marie GDNS Apt I
Nanuet, NY 10954-1916

Mailing address

7 Jeanne Marie GDNS Apt I
Nanuet, NY 10954-1916
Phone (845) 598-1315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address intake@liferevisions.com

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

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1265101695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 JEANNE MARIE GDNS APT I",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109541916",
            "telephone_number": "845-598-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 JEANNE MARIE GDNS APT I",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109541916",
            "telephone_number": "845-598-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYOUM",
        "first_name": "DESET",
        "middle_name": "TILAHUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "intake@liferevisions.com",
            "affiliation": "N",
            "address_1": "7 Jeanne Marie Gdns Apt I",
            "city": "Nanuet",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109541916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.