Individual provider Active NPI

Melissa Wergland, LCSW

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1811402993
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
099054 Issued in NY
Practice address
2020 Coney Island Ave
Brooklyn, NY 11223-2329
Phone
(718) 676-4299
NPI assigned
Dec 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 093515 NY
Social Worker 104100000X 099054 NY Primary

Addresses

Primary practice location

2020 Coney Island Ave
Brooklyn, NY 11223-2329

Mailing address

8635 21St Ave Apt 2E
Brooklyn, NY 11214-4033
Phone (908) 892-6327

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
I20220630000524 NY Practitioner - Clinical Social Worker 2860872371 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
099054NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children's Services, Inc. Clinical CurrentSince Jul 1, 2022 Accepting new patients
Jewish Board of Family & Childrens Services Inc CurrentSince Jul 1, 2022 Accepting new patients
Valera Medical, P.C. Social Worker CurrentSince Jun 1, 2022 Accepting new patients
Shine Medical PC Past Accepting new patients

Locations

2020 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 676-4210

134 N 4th St
Brooklyn, NY 11249

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

Organizations & group practices 4

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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1811402993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 21ST AVE APT 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144033",
            "telephone_number": "908-892-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232329",
            "telephone_number": "718-676-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERGLAND",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093515",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "099054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.