Active NPI
Sonia Ruth Cevallos, LCSW-R
- Clinical Social Worker
- Bayside, NY
National Provider Identifier
1710212014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R056755
- Practice address
- 216-15 Northem Blvd
2 Floor
Bayside, NY 11361 - Phone
- (718) 662-8910
- NPI assigned
- Oct 5, 2009
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R056755 | NY | Primary |
Addresses
Primary practice location
216-15 Northem Blvd
2 Floor
Bayside, NY 11361
Mailing address
216-15 Northem Blvd
2 Floor
Bayside, NY 11361
Phone (718) 662-8910
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 |
|---|---|---|---|
| R056755 | NY | MD | Clinical Social Worker |
| 056755 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271808000000",
"number": "1710212014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216-15 NORTHEM BLVD",
"address_2": "2 FLOOR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11361",
"telephone_number": "718-662-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216-15 NORTHEM BLVD",
"address_2": "2 FLOOR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "11361",
"telephone_number": "718-662-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEVALLOS",
"first_name": "SONIA",
"middle_name": "RUTH",
"name_prefix": "Mrs.",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-05",
"last_updated": "2010-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R056755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.