Individual provider Active NPI

Josephine Pereira

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1447570551
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073015 Issued in NY
Practice address
1413 Fulton St
Brooklyn, NY 11216-2607
Phone
(718) 636-4500
Fax
(718) 636-2998
NPI assigned
Jun 11, 2010
Last updated
Jun 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073015 NY Primary

Addresses

Primary practice location

1413 Fulton St
Brooklyn, NY 11216-2607

Mailing address

1413 Fulton St
Brooklyn, NY 11216-2607
Phone (718) 636-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120406000335 NY Practitioner - Clinical Social Worker 6608037296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073015NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Canino LCSW Psychotherapy PC CurrentSince May 28, 2024 Accepting new patients
Jal 28 LLC Past Accepting new patients
Blanton-Peale Institute Past Accepting new patients
Service Program for Older People PastSince Jan 9, 2017 Accepting new patients
Mermaid Management Inc PastSince Aug 3, 2019 Accepting new patients

Locations

68 Jay St
Ste 620
Brooklyn, NY 11201
Phone (646) 362-9382

1082 Victory Blvd
Staten Island, NY 10301
Phone (718) 815-3500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1447570551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162607",
            "telephone_number": "718-636-4500",
            "fax_number": "718-636-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162607",
            "telephone_number": "718-636-4500",
            "fax_number": "718-636-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "JOSEPHINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.