Kamilah Ellie Matthew, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

090724 Issued in NY

Practice address

11515 Sutphin Blvd
Jamaica, NY 11434-1020

Phone

(718) 659-4000

NPI assigned

Aug 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 11, 2021 through Jun 11, 2027

Medicare enrollment (NPD)

Not 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.

• Deeply Rooted Therapeutic Services LCSW PLLC

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1013847763
  NPD Authorized official

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1124250295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 AVENUE U # 1085",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295062",
            "telephone_number": "917-935-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341020",
            "telephone_number": "718-659-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEW",
        "first_name": "KAMILAH",
        "middle_name": "ELLIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018192",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tresa Mathew, M.S.ED CF-SLP
• Ellsworth Norman Mathews, PA
• Harinarine Mathura, PA
• Danielle Mathurin
• Briani Matlock
• Nia Matthew
• Rachelle Matthews, RN
• Dawn H Matthias
• Jensine J Mattis
• Melissa Veras Matysiak, PA

• Clinical Social Worker in Jamaica, NY
• Providers in Jamaica, 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 28, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.