Individual provider Active NPI

Mekala Poppy Pavlin, LCSW

  • Social Worker
  • New York, NY
National Provider Identifier
1942809249
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
128508701 Issued in NY
Practice address
275 W 96TH St Apt 23E
New York, NY 10025-6269
Phone
(917) 774-7612
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 128508701 NY Primary

Addresses

Primary practice location

275 W 96TH St Apt 23E
New York, NY 10025-6269

Mailing address

275 W 96TH St Apt 23E
New York, NY 10025-6269
Phone (917) 774-7612

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
128508701NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1942809249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST APT 23E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256269",
            "telephone_number": "917-774-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST APT 23E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256269",
            "telephone_number": "917-774-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIN",
        "first_name": "MEKALA",
        "middle_name": "POPPY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "128508701",
            "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 Oct 13, 2025; 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.