Taedra Pedonti, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093119-01 Issued in NY

Practice address

622 West 168TH St
VC4-East Room 403
New York, NY 11211

Phone

(212) 305-7248

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1760909303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 WEST 168TH ST.",
            "address_2": "VC4- EAST ROOM 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11211",
            "telephone_number": "212-305-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 WEST 168TH ST",
            "address_2": "VC4-EAST ROOM 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11211",
            "telephone_number": "212-305-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDONTI",
        "first_name": "TAEDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "100887",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093119-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsp7002@nyp.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "622 West 168th St",
            "address_2": "VC4-East Room 403",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pediatrics East of Ny PC
• Pediatrics of Nyc
• Maureen Pedicino, CRNP-AC
• Dorothy Elizabeth Pedisich, P.A.
• Timothy A Pedley, M.D.
• Alessia Carolina Pedoto, MD
• Elizabeth Pedowitz, MD
• Shayda Shamsabadi Pedram, MD
• Paula Araceli Pedrani, MD
• Adriana Marcela Pedraza Bermeo, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.