Gracianna Etcheverry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW119446 Issued in CA

Practice address

900 Walt Whitman Rd
Melville, NY 11747-2293

Phone

(516) 698-5511

NPI assigned

Aug 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Grace Etcheverry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1356697700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WASCO STATE PRISON",
            "address_2": "701 SCOFIELD AVE",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "93280",
            "telephone_number": "661-758-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472293",
            "telephone_number": "516-698-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETCHEVERRY",
        "first_name": "GRACIANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089524",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW119446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "ETCHEVERRY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Beatriz Espinoza
• Samantha Esposito
• Malka Esraeilian, MS
• Essential Manufacturing Corportion
• Tania Ivette Estrella
• Mitchella Etienne
• Arielle Melanie Eustache
• Lizel Lucia Eustaquio-Stover, L.AC.
• Nicole Ophelia Evans
• Rachel A Evans

• Clinical Social Worker in Melville, NY
• Providers in Melville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.