Theron Ison, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098569 Issued in NY

Practice address

16005 76TH Ave Apt 1B
Flushing, NY 11366-1108

Phone

(347) 564-3552

NPI assigned

May 6, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Still Waters LCSW PLLC

  • Clinical Social Worker
  • Flushing, NY
  • NPI 1871388280
  NPD Authorized official
• Long Island Consultation Center, Inc.

  • Clinical Social Worker
  • Elmhurst, NY
  • NPI 1295878577

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1598083123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16005 76TH AVE",
            "address_2": "1B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113661108",
            "telephone_number": "347-564-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16005 76TH AVE APT 1B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113661108",
            "telephone_number": "347-564-3552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9729 64th Rd",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113742240",
            "country_code": "US",
            "telephone_number": "718-896-3400",
            "fax_number": "718-459-5621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISON",
        "first_name": "THERON",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17336",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shura Iskhakova
• Farhana Islam, PHARMD
• Shalena Islam, MD
• Tanvira M Islam, MD
• Tanzeela Islam, DO
• Ernest S. Israel, M.D.
• Sara Sameh Israel
• Devorah Israelian
• Anthony Italiano, M.D.
• Adina Itshakov

• Clinical Social Worker in Flushing, NY
• Providers in Flushing, 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 Nov 7, 2024; 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.