Individual provider Active NPI

Dahlia Marie Wareham-Wilkerson, LCSWR

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1285796797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R042550-1 Issued in NY
Practice address
2021 Grand Concourse
Bronx, NY 10453-4304
Phone
(718) 960-0233
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R042550-1 NY Primary

Addresses

Primary practice location

2021 Grand Concourse
Bronx, NY 10453-4304

Mailing address

9 Chamin PLZ
Englewood, NJ 07631-3859
Phone (201) 894-1602

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
I20180822001284 NY Practitioner - Clinical Social Worker 7012266141 Practice locations: Bronx, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R042550-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas Hospital Past Accepting new patients
St. Barnabas Hospital Past Accepting new patients

Networks

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

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285796797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHAMIN PLZ",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313859",
            "telephone_number": "201-894-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534304",
            "telephone_number": "718-960-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAREHAM-WILKERSON",
        "first_name": "DAHLIA",
        "middle_name": "MARIE",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R042550-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.