Active NPI
Lesa Pemberton, LMSW
- Community/Behavioral Health Agency
- Brooklyn, NY
National Provider Identifier
1700245651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 081705-1
- Practice address
- 110 Wyona St
24
Brooklyn, NY 11207-2543 - Phone
- (917) 593-0356
- NPI assigned
- Feb 21, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 081705-1 | NY | Primary |
Addresses
Primary practice location
110 Wyona St
24
Brooklyn, NY 11207-2543
Mailing address
110 Wyona St
24
Brooklyn, NY 11207-2543
Phone (917) 593-0356
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 |
|---|---|---|---|
| 081705-1 | NY | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456012800000",
"number": "1700245651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WYONA ST",
"address_2": "24",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112072543",
"telephone_number": "917-593-0356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 WYONA ST",
"address_2": "24",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112072543",
"telephone_number": "917-593-0356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEMBERTON",
"first_name": "LESA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-21",
"last_updated": "2016-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NY",
"license": "081705-1",
"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 Feb 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.