Active NPI
Elizabeth Demis, LCSW-R
- Clinical Social Worker
- Albany, NY
National Provider Identifier
1174717730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 060313-1
- Practice address
- 4 Executive Park Dr
Albany, NY 12203-3718 - Phone
- (518) 438-9722
- NPI assigned
- Aug 28, 2007
- 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 | 060313-1 | NY | Primary |
Addresses
Primary practice location
4 Executive Park Dr
Albany, NY 12203-3718
Mailing address
4 Executive Park Dr
Albany, NY 12203-3718
Phone (518) 438-9722
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060313-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1174717730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 EXECUTIVE PARK DR",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033718",
"telephone_number": "518-438-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 EXECUTIVE PARK DR",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033718",
"telephone_number": "518-438-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMIS",
"first_name": "ELIZABETH",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-28",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "060313-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.