NPIMap

Organization Active NPI

Amavera LCSW PLLC

  • Community/Behavioral Health Agency
  • New York, NY
National Provider Identifier
1619602448
Registry record updated Jul 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AMAVERA LCSW PLLC
Practice address
230 E 79TH St Apt 7a
New York, NY 10075-1213
Phone
(917) 279-3789
NPI assigned
Jul 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2022

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

Authorized official

Name
Dr. Jillian Tucker, DSW, LCSWNPI 1295144350
Title
President
Phone
(917) 279-3789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

230 E 79TH St Apt 7a
New York, NY 10075-1213

Mailing address

515 Madison Ave
9TH Floor #9062
New York, NY 10022
Phone (917) 279-3789

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657929600000",
    "number": "1619602448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE",
            "address_2": "9TH FLOOR #9062",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "917-279-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 79TH ST APT 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751213",
            "telephone_number": "917-279-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAVERA LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-16",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-279-3789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; 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.