Sofia Marie Reverendo, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

120660 Issued in NY

Practice address

3340 Bainbridge Ave
Bronx, NY 10467-2802

Phone

(718) 696-3011

NPI assigned

Oct 10, 2023

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

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1417738030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 25TH ST APT 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103119",
            "telephone_number": "908-967-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672802",
            "telephone_number": "718-696-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVERENDO",
        "first_name": "SOFIA",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "120660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ma Leah Degala Retome, FNP
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• Jaclyn Rose Rettig, ATC
• Samantha Reuter, PA
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• Stephanie Lynn Revoredo

• Social Worker in Bronx, NY
• Providers in Bronx, 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 10, 2023; 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.