Individual provider Active NPI

Emma Dorfman, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1225127103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R067543 Issued in NY
Practice address
1670-78 E17 Street
Brooklyn, NY 11229
Phone
(718) 375-1200
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R067543 NY Primary

Addresses

Primary practice location

1670-78 E17 Street
Brooklyn, NY 11229

Mailing address

2355 E 12TH St
Apt.3C
Brooklyn, NY 11229-4212
Phone (917) 974-4458

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040608000951 NY Practitioner - Clinical Social Worker 4789674367 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R067543NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Jul 19, 2017 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Jul 19, 2017 Accepting new patients
Irina Zeylikman Psychotherapy LCSW, P.C. Clinical PastSince Oct 19, 2020 Accepting new patients
A Medical Office, PLLC PastSince Aug 1, 2003 Accepting new patients

Locations

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

Organizations & group practices 4

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225127103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 E 12TH ST",
            "address_2": "APT.3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294212",
            "telephone_number": "917-974-4458",
            "fax_number": "718-332-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670-78 E17 STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-375-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMAN",
        "first_name": "EMMA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R067543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.