Individual provider Active NPI

Evadne Viola Morrison-Taylor, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1285775320
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074302 Issued in NY
Practice address
8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone
(718) 206-6000
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 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 074302 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Jamaica, NY 11418-2897

Mailing address

21 Dale Dr
Farmingdale, NY 11735-2201
Phone (516) 843-7629

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
I20171102002852 NY Practitioner - Clinical Social Worker 9739445008 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074302NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Sep 10, 2017 Accepting new patients
Jamaica Hospital CurrentSince Sep 10, 2017 Accepting new patients

Locations

9009 Van Wyck Expy
Fl 2
Jamaica, NY 11435

9009 Van Wyck Expy
Jamaica, NY 11435
Phone (718) 206-5575

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1285775320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DALE DR",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352201",
            "telephone_number": "516-843-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON-TAYLOR",
        "first_name": "EVADNE",
        "middle_name": "VIOLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.