Active NPI
Esperanta Dupervil, LCSW
- Clinical Social Worker
- Rosedale, NY
National Provider Identifier
1700241981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 090249
- Practice address
- 25617 Francis Lewis Blvd
Rosedale, NY 11422-3332 - Phone
- (347) 757-1848
- NPI assigned
- Dec 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 72 067870 | NY | |
| Clinical Social Worker | 1041C0700X | 090249 | NY | Primary |
Addresses
Primary practice location
25617 Francis Lewis Blvd
Rosedale, NY 11422-3332
Mailing address
882 Bergen St
Brooklyn, NY 11238
Phone (718) 613-7510
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72 067870 | NY | MD | Social Worker |
| 090249 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1700241981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "882 BERGEN ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11238",
"telephone_number": "718-613-7510",
"fax_number": "718-613-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25617 FRANCIS LEWIS BLVD",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114223332",
"telephone_number": "347-757-1848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPERVIL",
"first_name": "ESPERANTA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-15",
"last_updated": "2021-08-25",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "72 067870",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "090249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.