Individual provider Active NPI

Alba Ardila, LCSW

  • Social Worker
  • Rego Park, NY
National Provider Identifier
1982701876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0565241 Issued in NY
Practice address
98120 Queens Blvd
Apt 1C
Rego Park, NY 11374
Phone
(718) 830-0246
Fax
(718) 830-9088
NPI assigned
Sep 20, 2006
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
Social Worker 104100000X 0565241 NY Primary

Addresses

Primary practice location

98120 Queens Blvd
Apt 1C
Rego Park, NY 11374

Mailing address

98120 Queens Blvd
Apt 1C
Rego Park, NY 11374
Phone (718) 830-0246

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
I20180405000818 NY Practitioner - Clinical Social Worker 8921361908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0565241NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Center for Mental Health, Inc. CurrentSince Feb 28, 2018 Accepting new patients
Families and Individuals in Recovery CurrentSince Feb 28, 2018 Accepting new patients
Comprehensive Counseling LCSW, PLLC PastSince Mar 1, 2008 Accepting new patients

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982701876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "address_2": "APT 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-830-0246",
            "fax_number": "718-830-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "address_2": "APT 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-830-0246",
            "fax_number": "718-830-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDILA",
        "first_name": "ALBA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0565241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.