Individual provider Active NPI

Yuliya Vaynrub, LCSW

  • Clinical Social Worker
  • Valley Stream, NY
National Provider Identifier
1174748859
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074671-1 Issued in NY
Practice address
853 Talbot Ave
Valley Stream, NY 11581-3111
Phone
(917) 657-0290
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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 074671-1 NY Primary

Addresses

Primary practice location

853 Talbot Ave
Valley Stream, NY 11581-3111

Mailing address

853 Talbot Ave
Valley Stream, NY 11581-3111
Phone (917) 657-0290

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
074671-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services of Ny PC Past Accepting new patients
New York Psychiatric Services, P.C. PastSince May 1, 2000 Accepting new patients

Organizations & group practices 2

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1174748859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 TALBOT AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813111",
            "telephone_number": "917-657-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 TALBOT AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813111",
            "telephone_number": "917-657-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNRUB",
        "first_name": "YULIYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074671-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.