Individual provider Active NPI

Sarah Wilda, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1285097253
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083966 Issued in NY
Practice address
400 8TH Ave FL 2
New York, NY 10001-4819
Phone
(919) 265-7460
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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 083966 NY Primary

Addresses

Primary practice location

400 8TH Ave FL 2
New York, NY 10001-4819

Mailing address

400 8TH Ave FL 2
New York, NY 10001-4819
Phone (919) 265-7460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420000089 NY Practitioner - Clinical Social Worker 2860755170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interborough Developmental and Consultation Center IncGroup PAC ID 7911898192, 167 clinicians

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083966NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Catholic Charities Neighborhood Services, Inc. CurrentSince Mar 7, 2018 Accepting new patients

Locations

1623 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 377-5755

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

191 Joralemon St
Fl 11
Brooklyn, NY 11201

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1285097253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 8TH AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014819",
            "telephone_number": "919-265-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 8TH AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014819",
            "telephone_number": "919-265-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDA",
        "first_name": "SARAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.