Individual provider Active NPI

Elissa M Owens, LCSW

  • Clinical Social Worker
  • Schenectady, NY
National Provider Identifier
1093284267
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092856 Issued in NY
Practice address
1023 State St
Schenectady, NY 12307-1511
Phone
(518) 243-3300
Fax
(518) 377-9151
NPI assigned
Nov 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 092856 NY Primary

Addresses

Primary practice location

1023 State St
Schenectady, NY 12307-1511

Mailing address

1023 State St
Schenectady, NY 12307-1511
Phone (518) 243-3300

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
I20220708001206 NY Practitioner - Clinical Social Worker 0244610269 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
092856NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Mar 22, 2022 Accepting new patients

Locations

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

1023 State St
Schenectady, NY 12307
Phone (518) 243-3300

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

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": "1542412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1093284267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071511",
            "telephone_number": "518-243-3300",
            "fax_number": "518-377-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071511",
            "telephone_number": "518-243-3300",
            "fax_number": "518-377-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ELISSA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-17",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.