Active NPI
Eliza Plenty, LCSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1154917680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 092942
- Practice address
- 1161 Bedford Ave # 1031
Brooklyn, NY 11216-1614 - Phone
- (718) 407-4759
- NPI assigned
- Dec 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 092942 | NY | Primary |
Addresses
Primary practice location
1161 Bedford Ave # 1031
Brooklyn, NY 11216-1614
Mailing address
1161 Bedford Ave # 1031
Brooklyn, NY 11216-1614
Phone (718) 407-4759
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220922002827 | NY | Order and Referring Only - Clinical Social Worker | 3375928658 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 092942 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Mental Health | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719014400000",
"number": "1154917680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1161 BEDFORD AVE # 1031",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112161614",
"telephone_number": "718-407-4759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1161 BEDFORD AVE # 1031",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112161614",
"telephone_number": "718-407-4759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLENTY",
"first_name": "ELIZA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-18",
"last_updated": "2024-06-22",
"certification_date": "2024-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "092942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.