Individual provider Active NPI

Elisabeth Holbein, LCSW

  • Clinical Social Worker
  • Baldwinsville, NY
National Provider Identifier
1053858043
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090900 Issued in NY
Practice address
15 E Genesee St Ste 203
Baldwinsville, NY 13027-2564
Phone
(315) 303-8901
NPI assigned
Jan 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X NY
Clinical Social Worker 1041C0700X 090900 NY Primary

Addresses

Primary practice location

15 E Genesee St Ste 203
Baldwinsville, NY 13027-2564

Mailing address

PO Box 608
Wampsville, NY 13163-0608
Phone (315) 366-2327

Other practice location 1

1519 Nye Rd
Lyons, NY 14489-9133
Phone (315) 946-5722

Other practice location 2

138 N Court St
Wampsville, NY 13163-7714
Phone (315) 366-2327

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
I20210310000686 NY Practitioner - Clinical Social Worker 6507272903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090900NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC CurrentSince May 29, 2023 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

890 7th North St
Ste 200
Liverpool, NY 13088
Phone (315) 200-1056

890 7th North St
Ste 200100
Liverpool, NY 13088

3300 James St
Ste 100
Syracuse, NY 13206

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": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1053858043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "WAMPSVILLE",
            "state": "NY",
            "postal_code": "131630608",
            "telephone_number": "315-366-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E GENESEE ST STE 203",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272564",
            "telephone_number": "315-303-8901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 Nye Rd",
            "address_purpose": "LOCATION",
            "city": "Lyons",
            "state": "NY",
            "postal_code": "144899133",
            "country_code": "US",
            "telephone_number": "315-946-5722",
            "fax_number": "315-946-5722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "138 N Court St",
            "address_purpose": "LOCATION",
            "city": "Wampsville",
            "state": "NY",
            "postal_code": "131637714",
            "country_code": "US",
            "telephone_number": "315-366-2327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLBEIN",
        "first_name": "ELISABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-27",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinsville, NY

Sources for this page

Verify at the official NPI Registry.