Individual provider Active NPI

Sandra Lee Edwards, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1336387398
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
073874 Issued in NY
Practice address
633 Olmstead Ave
Suite # 3a
Bronx, NY 10473-1745
Phone
(718) 792-5725
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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 073874 NY Primary

Addresses

Primary practice location

633 Olmstead Ave
Suite # 3a
Bronx, NY 10473-1745

Mailing address

633 Olmstead Ave
Suite # 3a
Bronx, NY 10473-1745
Phone (718) 792-5725

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
073874NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1336387398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 OLMSTEAD AVE",
            "address_2": "SUITE # 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731745",
            "telephone_number": "718-792-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 OLMSTEAD AVE",
            "address_2": "SUITE # 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731745",
            "telephone_number": "718-792-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.