Matthew Yetsko, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084151 Issued in NY

Practice address

68 Jay St Ste 311
Brooklyn, NY 11201-8360

Phone

(347) 560-8591

NPI assigned

Oct 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Canino LCSW Psychotherapy, PCGroup PAC ID 2961589577, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Canino LCSW Psychotherapy PC

  • Health Maintenance Organization
  • Brooklyn, NY
  • NPI 1225220072
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1350777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1083967574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST APT 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011443",
            "telephone_number": "347-560-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 JAY ST STE 311",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112018360",
            "telephone_number": "347-560-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETSKO",
        "first_name": "MATTHEW",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-21",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdel Karimou Babatounde Yessoufou
• Yesterday'S Youth LLC
• Mesrob Yeterian, MD
• Sean Yetman, MD
• Shauna Yetman
• Adrian Yeung, D.D.S.
• Cindy Yeung
• Diana Yeung
• Eddie Yeung, RPH
• Hiu Lee Yeung

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.