Active NPI
Lily Brefo
- Social Worker
- Jackson Heights, NY
National Provider Identifier
1982251831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 104811
- Practice address
- 9114 37TH Ave
Jackson Heights, NY 11372-7920 - Phone
- (718) 779-1600
- NPI assigned
- Aug 23, 2019
- Reactivated
- Jun 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 24739 | MD | |
| Social Worker | 104100000X | 104811 | NY | Primary |
Addresses
Primary practice location
9114 37TH Ave
Jackson Heights, NY 11372-7920
Mailing address
9114 37TH Ave
Jackson Heights, NY 11372-7920
Phone (718) 779-1600
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24739 | MD | MD | Mental Health Counselor |
| 104811 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1982251831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9114 37TH AVE",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727920",
"telephone_number": "718-779-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9114 37TH AVE",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727920",
"telephone_number": "718-779-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREFO",
"first_name": "LILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-23",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"deactivation_date": "2020-07-20",
"reactivation_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "24739",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "104811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.