Individual provider Active NPI

Valery Yezersky, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1235614322
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092817 Issued in NY
Practice address
1701 Avenue P
Brooklyn, NY 11229-1205
Phone
(917) 412-7177
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 092817 NY Primary
Social Worker 104100000X 104909 NY

Addresses

Primary practice location

1701 Avenue P
Brooklyn, NY 11229-1205

Mailing address

1685 Ocean Ave Apt 2E
Brooklyn, NY 11230-5428
Phone (917) 412-7177

Other practice location 1

2454 E 14th St
Brooklyn, NY 11235-3902
Phone (718) 288-8883

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104909NYMDSocial Worker
092817NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valery Yezersky LCSW P.C. Clinical Current Accepting new patients
Mind Matters LCSW PC Social Worker PastSince Dec 23, 2012 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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1235614322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 OCEAN AVE APT 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305428",
            "telephone_number": "917-412-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 AVENUE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291205",
            "telephone_number": "917-412-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2454 E 14th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112353902",
            "country_code": "US",
            "telephone_number": "718-288-8883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEZERSKY",
        "first_name": "VALERY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092817",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.