Yevgeniya Gorodetskaya, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R062508-1 Issued in NY

Practice address

1670-78 East 17TH Street
3Rd FL.
Brooklyn, NY 11229

Phone

(718) 375-1200

Fax

(718) 382-3358

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Interborough Developmental and Consultation Center IncGroup PAC ID 7911898192, 167 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

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

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.

• Interborough Developmental and Consultation Center, Inc.

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment Care Compare group
• Interborough Developmental and Consultation Center

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1386663904
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225101017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 W 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232726",
            "telephone_number": "718-336-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670-78 EAST 17TH STREET",
            "address_2": "3RD FL.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-375-1200",
            "fax_number": "718-382-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORODETSKAYA",
        "first_name": "YEVGENIYA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R062508-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Gorlov
• Cynthia Gorman, L.AC
• Kathleen Mary Gormley
• Olga Gornostay, PHARMD, RPH
• Tetyana Gorodetskaya
• Yevgeniya Gorodetskaya, MSED
• Elina Gorodetsky, SLP
• Rina Gorodetsky, MD
• Adele N/a Gorodin
• Lyubov Gorodin, M.D.

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.