Individual provider Active NPI

Poonam Bala Dharni, LCSW-R

  • Social Worker
  • Bronx, NY
National Provider Identifier
1750428413
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
077887 Issued in NY
Practice address
2737 3Rd Ave
Bronx, NY 10451-5801
Phone
(718) 838-1029
Fax
(718) 838-1010
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 077887 NY Primary

Addresses

Primary practice location

2737 3Rd Ave
Bronx, NY 10451-5801

Mailing address

6207 84TH St Apt E61
Middle Village, NY 11379-2030
Phone (310) 383-9912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121115000535 NY Practitioner - Clinical Social Worker 0446401608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077887NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. CurrentSince Sep 19, 2015 Accepting new patients
Long Island Consultation Center PastSince Aug 15, 2021 Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1750428413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 84TH ST APT E61",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792030",
            "telephone_number": "310-383-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515801",
            "telephone_number": "718-838-1029",
            "fax_number": "718-838-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARNI",
        "first_name": "POONAM",
        "middle_name": "BALA",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "077887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.