Individual provider Active NPI

Devora Leah Herson

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1316722432
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
125128-01 Issued in NY
Practice address
365 Willoughby Ave
Brooklyn, NY 11205-5191
Phone
(718) 875-6900
NPI assigned
Aug 28, 2023
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 125128-01 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

365 Willoughby Ave
Brooklyn, NY 11205-5191

Mailing address

648 Maple St Apt 3a
Brooklyn, NY 11203-1377

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
125128-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pesach Tikvah Hope Development Inc PastSince Sep 5, 2023 Accepting new patients
Pesach Tikvah Hope Development Inc Social Worker PastSince Sep 5, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1316722432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 MAPLE ST APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 WILLOUGHBY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112055191",
            "telephone_number": "718-875-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSON",
        "first_name": "DEVORA",
        "middle_name": "LEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "125128-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "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 Dec 6, 2024; 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.