Individual provider Active NPI

Elisa Briavael Meredith, LCSW

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1144478199
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 035140 Issued in NY
Practice address
877 Madison Ave
Albany, NY 12208-3321
Phone
(518) 482-8856
Fax
(518) 489-5839
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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 LCSW 035140 NY Primary

Addresses

Primary practice location

877 Madison Ave
Albany, NY 12208-3321

Mailing address

877 Madison Ave
Albany, NY 12208-3321
Phone (518) 482-8856

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
I20170508001473 NY Practitioner - Clinical Social Worker 6305123936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
LCSW 035140NYMDClinical Social Worker
035140NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Behavioral Health Ipa PLLC CurrentSince Apr 12, 2017 Accepting new patients
Joseph Ippolito Clinical Past Accepting new patients
Jewish Family Services of Northeastern New York Past Accepting new patients

Locations

10 McKown Rd
Ste 102
Albany, NY 12203
Phone (518) 689-0244

Organizations & group practices 3

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1144478199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 MADISON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083321",
            "telephone_number": "518-482-8856",
            "fax_number": "518-489-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 MADISON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083321",
            "telephone_number": "518-482-8856",
            "fax_number": "518-489-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "ELISA",
        "middle_name": "BRIAVAEL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "LCSW 035140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.