Elina Polyakov, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

070111-1 Issued in NY

Practice address

150 Airport Executive Park
Suite 152
Nanuet, NY 10954-5261

Phone

(646) 312-9473

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polyakov Psychotherapy LCSW PC

  • Clinical Social Worker
  • Paramus, NJ
  • NPI 1275417792
  NPD Authorized official

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1205000833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40-09 MONROE ST",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104950",
            "telephone_number": "646-312-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AIRPORT EXECUTIVE PARK",
            "address_2": "SUITE 152",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545261",
            "telephone_number": "646-312-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYAKOV",
        "first_name": "ELINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05435900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070111-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jude Placio, PTA
• PM Pediatrics of Bayside PLLC
• Andrew Boris Podymow
• Mildred Pollas
• Dijanaise Pollock
• Richard L Popowitz, MD
• Yeva Posner, RN, IBCLC
• Joanne Pritzlaff, OTR
• Procore Physical Therapy P.C.
• Progressive Rehabilitation Physical Therapy

• Clinical Social Worker in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.