Individual provider Active NPI

Debra J Kearse-Thomas, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1336905553
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089666 Issued in NY
Practice address
117 Jefferson Ave Apt 23
Brooklyn, NY 11216-1674
Phone
(917) 882-5323
NPI assigned
Feb 26, 2024
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 089666 NY Primary

Addresses

Primary practice location

117 Jefferson Ave Apt 23
Brooklyn, NY 11216-1674

Mailing address

117 Jefferson Ave Apt 23
Brooklyn, NY 11216-1674
Phone (917) 882-5323

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
I20241015003100 NY Practitioner - Clinical Social Worker 5597297564 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 20, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Jul 1, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1336905553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 JEFFERSON AVE APT 23",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112161674",
            "telephone_number": "917-882-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 JEFFERSON AVE APT 23",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112161674",
            "telephone_number": "917-882-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARSE-THOMAS",
        "first_name": "DEBRA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.