Individual provider Active NPI

Victor Antonio Tejera, ED.D., LCSW, ACSW

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1356006423
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18593 Issued in FL
Practice address
7875 SW 104TH St Ste 101
Miami, FL 33156-2642
Phone
(305) 740-8998
NPI assigned
Nov 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SW18593 FL
Clinical Social Worker 1041C0700X SW18593 FL Primary

Addresses

Primary practice location

7875 SW 104TH St Ste 101
Miami, FL 33156-2642

Mailing address

7875 SW 104TH St Ste 101
Miami, FL 33156-2642

Other identifiers 1

IdentifierTypeStateIssuer
0MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vtejera@jcsfl.org Direct

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
SW18593FLMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1356006423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7875 SW 104TH ST STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7875 SW 104TH ST STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562642",
            "telephone_number": "305-740-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJERA",
        "first_name": "VICTOR",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "ED.D., LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "SW18593",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vtejera@jcsfl.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7875 SW 104th St Ste 101",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331562642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.