Ascending Psychotherapy-PW LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

075520 Issued in NY

Legal business name

ASCENDING PSYCHOTHERAPY-PW LCSW PC

Practice address

14722 Village Rd Apt 82B
Jamaica, NY 11435-6307

Phone

(917) 224-5793

NPI assigned

Dec 5, 2017

Organization subpart

No

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

Authorized official

Name

Pamela Wallace, LCSW-RNPI 1457493900

Title

Owner

Phone

(917) 224-5793

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Wallace, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1457493900
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1427563014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14722 VILLAGE RD APT 82B",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114356307",
            "telephone_number": "917-224-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14722 VILLAGE RD APT 82B",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114356307",
            "telephone_number": "917-224-5793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13129 Farmers Blvd",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114344123",
            "country_code": "US",
            "telephone_number": "917-224-5793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASCENDING PSYCHOTHERAPY-PW LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-224-5793",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bosede Asebiomo
• Patrick Scott Ashe, RN
• Yakov Asherov, M.A.
• Salman Ashfaq
• Jodiane Ashpole, FNP

• Clinical Social Worker in Jamaica, NY
• Providers in Jamaica, 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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.