Individual provider Active NPI

Jessica Oliveira-Haddad, LCSW

  • Clinical Social Worker
  • Elmhurst, NY
National Provider Identifier
1174026595
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10037601 Issued in NY
Practice address
9131 Queens Blvd
Elmhurst, NY 11373-5555
Phone
(718) 896-3400
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 10037601 NY Primary

Addresses

Primary practice location

9131 Queens Blvd
Elmhurst, NY 11373-5555

Mailing address

630 Tulip Ave
Floral Park, NY 11001-3755
Phone (917) 362-0777

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
I20250916004075 NY Practitioner - Clinical Social Worker 4688178379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9131 Queens Blvd
Elmhurst, NY 11373-5591

9131 Queens Blvd
Suite 222
Elmhurst, NY 11373-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10037601NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Consultation Center, Inc. Clinical CurrentSince Jul 2, 2025 Accepting new patients
Long Island Consultation Center PastSince Aug 15, 2021 Accepting new patients
Ahdia Alma Counseling, LCSW, PLLC PastSince Aug 25, 2025 Accepting new patients
Support Evaluation and Intervention Services LCSW P.C Clinical Past Accepting new patients

Locations

9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400

9131 Queens Blvd
Flushing, NY 11373
Phone (718) 454-2222

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations & group practices 4

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1174026595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TULIP AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013755",
            "telephone_number": "917-362-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735555",
            "telephone_number": "718-896-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEIRA-HADDAD",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "10037601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.