Individual provider Active NPI

Brandon Tyler Sargent

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1861176950
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122174 Issued in NY
Practice address
2825 3Rd Ave Ste 402
Bronx, NY 10455-4073
Phone
(718) 520-8000
NPI assigned
Jun 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 122174 NY Primary

Addresses

Primary practice location

2825 3Rd Ave Ste 402
Bronx, NY 10455-4073

Mailing address

2248 Broadway # 1852
New York, NY 10024-5805
Phone (586) 738-1579

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
122174NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Athenapsych LLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

2825 3rd Ave
Ste 402
Bronx, NY 10455
Phone (718) 360-0555

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1861176950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 BROADWAY # 1852",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245805",
            "telephone_number": "586-738-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 3RD AVE STE 402",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554073",
            "telephone_number": "718-520-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "BRANDON",
        "middle_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "122174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.