Individual provider Active NPI

Adaiah Tanisha Lassalle, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1871647131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0745121 Issued in NY
Practice address
401 E 147TH St
New Beginning Community Counseling Center
Bronx, NY 10455
Phone
(718) 402-5250
NPI assigned
Jan 23, 2007
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 0745121 NY Primary

Addresses

Primary practice location

401 E 147TH St
New Beginning Community Counseling Center
Bronx, NY 10455

Mailing address

27 Red Oaks Mill Rd
Poughkeepsie, NY 12603
Phone (917) 488-2218

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
I20040614000210 NY Practitioner - Clinical Social Worker 9537143144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0745121NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Daytop Village, Inc. CurrentSince Jun 9, 2019 Accepting new patients
Thrive Psychotherapy Practice LCSW PLLC Current Accepting new patients
Samaritan Daytop Village, Inc. CurrentSince Jun 9, 2019 Accepting new patients
Empire Drugstore Inc PastSince Mar 1, 2020 Accepting new patients

Locations

2780 3rd Ave
Bronx, NY 10455
Phone (718) 402-5244

477 Willis Ave
#479
Bronx, NY 10455

250 Grand Concourse
Bronx, NY 10451
Phone (718) 292-2240

13802 Queens Blvd
Jamaica, NY 11435
Phone (718) 298-5100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871647131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RED OAKS MILL RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "917-488-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 147TH ST",
            "address_2": "NEW BEGINNING COMMUNITY COUNSELING CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10455",
            "telephone_number": "718-402-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSALLE",
        "first_name": "ADAIAH",
        "middle_name": "TANISHA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0745121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.