Individual provider Active NPI

Elizabeth Palmieri, LCSW

  • Clinical Social Worker
  • Port Jefferson, NY
National Provider Identifier
1174990527
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083162-1 Issued in NY
Practice address
118 Spring St
Port Jefferson, NY 11777-1817
Phone
(631) 476-0564
Fax
(631) 476-9322
NPI assigned
Sep 1, 2015
Last updated
May 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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 083162-1 NY Primary

Addresses

Primary practice location

118 Spring St
Port Jefferson, NY 11777-1817

Mailing address

11 Waterview Ave
Ronkonkoma, NY 11779-3057
Phone (631) 495-4781

Other practice location 1

220 Main St
Center Moriches, NY 11934-3516
Phone (631) 874-2700

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
083162-1NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1174990527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WATERVIEW AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793057",
            "telephone_number": "631-495-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SPRING ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771817",
            "telephone_number": "631-476-0564",
            "fax_number": "631-476-9322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Main St",
            "address_purpose": "LOCATION",
            "city": "Center Moriches",
            "state": "NY",
            "postal_code": "119343516",
            "country_code": "US",
            "telephone_number": "631-874-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMIERI",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083162-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.