Individual provider Active NPI

Teresa Engo

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1750547667
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077401 Issued in NY
Practice address
937 Fulton St
Brooklyn, NY 11238-2347
Phone
(718) 789-1681
Fax
(718) 789-4308
NPI assigned
Jul 30, 2008
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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 077401 NY Primary
Social Worker 104100000X 063125 NY

Addresses

Primary practice location

937 Fulton St
Brooklyn, NY 11238-2347

Mailing address

22 Chapel St
Brooklyn, NY 11201-1903
Phone (718) 789-1681

Other identifiers 1

IdentifierTypeStateIssuer
063125OtherNYLMSW

Other names 1

  • Teresa Engo Professional name

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
077401NYMDClinical Social Worker
063125NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sankofa-Clearview Services LLC CurrentSince Mar 20, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1750547667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHAPEL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011903",
            "telephone_number": "718-789-1681",
            "fax_number": "718-789-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382347",
            "telephone_number": "718-789-1681",
            "fax_number": "718-789-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGO",
        "first_name": "TERESA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077401",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "063125",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "063125",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "ENGO",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Aug 28, 2019; 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.