Celisa Malika Vanderburg

Primary specialty

Social WorkerTaxonomy code 104100000X

License

127117 Issued in NY

Practice address

64 Old Riverhead Rd
Westhampton Beach, NY 11978-1451

Phone

(646) 655-8204

NPI assigned

Oct 20, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1407723190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 TOWNEHOUSE DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272824",
            "telephone_number": "646-655-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 OLD RIVERHEAD RD",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119781451",
            "telephone_number": "646-655-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBURG",
        "first_name": "CELISA",
        "middle_name": "MALIKA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "127117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dale Verga, CASAC
• Peter Steven Wagoner, OD

• Social Worker in Westhampton Beach, NY
• Providers in Westhampton Beach, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.