Individual provider Active NPI

Kachina Myers, LMSW, LCSW, ACSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1811361819
Registry record updated Nov 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R041903 Issued in NY
Practice address
85 5TH Ave
Suite 937
New York, NY 10003-3019
Phone
(212) 727-2209
NPI assigned
Nov 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2015

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 R041903 NY Primary

Addresses

Primary practice location

85 5TH Ave
Suite 937
New York, NY 10003-3019

Mailing address

85 5TH Ave
Suite 937
New York, NY 10003-3019
Phone (212) 727-2209

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
R041903NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1447459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447459200000",
    "number": "1811361819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 5TH AVE",
            "address_2": "SUITE 937",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033019",
            "telephone_number": "212-727-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 5TH AVE",
            "address_2": "SUITE 937",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033019",
            "telephone_number": "212-727-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KACHINA",
        "name_prefix": "Ms.",
        "credential": "LMSW, LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-14",
        "last_updated": "2015-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.