Individual provider Active NPI

Tara Wolfert, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1619177458
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P058904
Practice address
4809 Avenue N Ste 346
Brooklyn, NY 11234-3711
Phone
(718) 376-9287
Fax
(718) 376-9287
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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 P058904 Primary

Addresses

Primary practice location

4809 Avenue N Ste 346
Brooklyn, NY 11234-3711

Mailing address

4809 Avenue N Ste 346
Brooklyn, NY 11234-3711
Phone (718) 376-9287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Associations of New York State, Inc. Current Accepting new patients
Federation Employment and Guidance Service, Inc Past Accepting new patients
United Cerebral Palsy Assoc of Nys Inc. Past Accepting new patients

Locations

979 Cross Bronx Expy
Bronx, NY 10460
Phone 71866575653009

40 Rector St
Fl 15
New York, NY 10006
Phone (929) 647-4796

2324 Forest Ave
Staten Island, NY 10303
Phone (718) 447-0200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1619177458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 AVENUE N STE 346",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343711",
            "telephone_number": "718-376-9287",
            "fax_number": "718-376-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 AVENUE N STE 346",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343711",
            "telephone_number": "718-376-9287",
            "fax_number": "718-376-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFERT",
        "first_name": "TARA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "P058904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.