Individual provider Active NPI

Mary Forero Ekwall, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1790731990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P047175 Issued in NY
Practice address
540 East 13 Street
New York, NY 10009
Phone
(212) 387-7419
Fax
(212) 387-7432
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P047175 NY Primary

Addresses

Primary practice location

540 East 13 Street
New York, NY 10009

Mailing address

2064 31 Street
Apt C8
Astoria, NY 11105-2528
Phone (718) 726-5451

Other identifiers 1

IdentifierTypeStateIssuer
01763455MedicaidNY

Other names 1

  • Maria del Rosario Forero Former name

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
I20161125000055 NY Order and Referring Only - Clinical Social Worker 7012102627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P047175NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790731990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 31 STREET",
            "address_2": "APT C8",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052528",
            "telephone_number": "718-726-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 EAST 13 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10009",
            "telephone_number": "212-387-7419",
            "fax_number": "212-387-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKWALL",
        "first_name": "MARY",
        "middle_name": "FORERO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P047175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01763455",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA DEL",
            "last_name": "FORERO",
            "middle_name": "ROSARIO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.