Individual provider Active NPI

Victoria L Avila, L.C.S.W.

  • Clinical Social Worker
  • Hasbrouck Heights, NJ
National Provider Identifier
1730397993
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05366700 Issued in NJ
Practice address
249 Boulevard
Hasbrouck Heights, NJ 07604-1902
Phone
(201) 393-0370
Fax
(201) 393-9209
NPI assigned
May 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 074925 NY
Clinical Social Worker 1041C0700X 44SC05366700 NJ Primary

Addresses

Primary practice location

249 Boulevard
Hasbrouck Heights, NJ 07604-1902

Mailing address

249 Boulevard
Hasbrouck Heights, NJ 07604-1902
Phone (201) 393-0370

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

LicenseStateTypeSpecialty
44SC05366700NJMDClinical Social Worker
074925NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1730397993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 BOULEVARD",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076041902",
            "telephone_number": "201-393-0370",
            "fax_number": "201-393-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 BOULEVARD",
            "city": "HASBROUCK HEIGHTS",
            "state": "NJ",
            "postal_code": "076041902",
            "telephone_number": "201-393-0370",
            "fax_number": "201-393-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "VICTORIA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-20",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074925",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05366700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hasbrouck Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.