Linda M Fodera, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078597 Issued in NY

Practice address

21245 26TH Ave Ste 4a
Bayside, NY 11360-1901

Phone

(917) 444-0468

NPI assigned

Oct 18, 2010

Last updated

Apr 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1689984163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21245 26TH AVE",
            "address_2": "SUITE 4A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21245 26TH AVE STE 4A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601901",
            "telephone_number": "917-444-0468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODERA",
        "first_name": "LINDA",
        "middle_name": "M",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bayside, NY
• Providers in Bayside, 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 Apr 23, 2018; 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.