Individual provider Active NPI

Maritza Cardona-Campbell, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1598073553
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R044727-1 Issued in NY
Practice address
513 W 166TH St FL 4
New York, NY 10032
Phone
(121) 292-8830
Fax
(212) 292-8839
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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 R044727-1 NY Primary

Addresses

Primary practice location

513 W 166TH St FL 4
New York, NY 10032

Mailing address

513 W 166TH St FL 4
New York, NY 10032-4207
Phone (121) 292-8830

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
I20240227002295 NY Order and Referring Only - Clinical Social Worker 9436404407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R044727-1NYMDClinical Social Worker
044727NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1598073553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 W 166TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100324207",
            "telephone_number": "121-292-8830",
            "fax_number": "212-292-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 W 166TH ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "121-292-8830",
            "fax_number": "212-292-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA-CAMPBELL",
        "first_name": "MARITZA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R044727-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.