Katherine Jasper-Vera, LMSW
Individual provider Active NPI Social Worker · Bardonia, NY
NPI 1689247116 · NPPES record last updated Jul 22, 2021
Key facts
- NPI
- 1689247116
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 063273 (NY)
- Practice address
- 104 Renee LN
Bardonia, NY 10954-2142 - Phone
- (917) 213-6812
- NPI assigned
- Jul 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 063273 | NY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | 063273 | NY | Yes |
Addresses
Primary practice location
104 Renee LN
Bardonia, NY 10954-2142
Mailing address
104 Renee LN
Bardonia, NY 10954-2142
Phone (917) 213-6812
Other providers in Bardonia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.