Spencer Bastedo, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

125205-01 Issued in NY

Practice address

3704 91St St Ste E
Jackson Heights, NY 11372-7909

Phone

(917) 755-5619

NPI assigned

Mar 5, 2025

Sex

Male

Sole proprietor

Yes

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": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1487452520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 35TH AVE APT 6I",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725315",
            "telephone_number": "917-755-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 91ST ST STE E",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727909",
            "telephone_number": "917-755-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTEDO",
        "first_name": "SPENCER",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "125205-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latanya Marie Bartholomew, CPNP-PC
• Barton M Appel MD
• Ofir Baruk, DDS
• Shannen Ivy Rillera Bascao
• Antionette Bassi Rojas, MSW, CASAC
• Chaitanya Bathla, PHYSICAL THERAPIST
• Krystal J Batista
• Poonam Batra
• Shiref Ezzat Bayoumi, PT
• Ke'Shea S Bazemore, MSW

• Clinical Social Worker in Jackson Heights, NY
• Providers in Jackson Heights, 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 Aug 22, 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.