Individual provider Active NPI

Elana Naclerio, MA, ATR-BC, LCAT

  • Art Therapist
  • Fort Salonga, NY
National Provider Identifier
1124584495
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
002088 Issued in NY
Practice address
10 Soundview Dr
Fort Salonga, NY 11768-1445
Phone
(631) 546-8400
NPI assigned
Feb 12, 2019
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 002088 NY Primary

Addresses

Primary practice location

10 Soundview Dr
Fort Salonga, NY 11768-1445

Mailing address

10 Soundview Dr
Fort Salonga, NY 11768-1445
Phone (631) 546-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
002088NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rain Or Shine Creative Arts Therapy Services, PLLC Art Therapist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1124584495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SOUNDVIEW DR",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117681445",
            "telephone_number": "631-546-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOUNDVIEW DR",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117681445",
            "telephone_number": "631-546-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACLERIO",
        "first_name": "ELANA",
        "name_prefix": "Ms.",
        "credential": "MA, ATR-BC, LCAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Salonga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.