Elisa Weidenbaum Waters, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

106-335-1 Issued in NY

Practice address

17 E Carver St
Huntington, NY 11743-3409

Phone

(631) 673-5433

NPI assigned

Dec 18, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1235725722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GENEVA PL",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401906",
            "telephone_number": "516-220-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "631-673-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ELISA",
        "middle_name": "WEIDENBAUM",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106-335-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senaye Walters, LPN
• George L. Wang, M.D.
• Lara Beth Wanlass, MS
• Amy Beth Wapner, M.S., ADTR, NYS CAT
• Waterfront Chiropractic P.C.
• Lauren M Waters, DUAL MA
• Jarvis Watson
• Melissa H Wayne, CASACT
• Zachary Thomas Webb, D.O.
• Joseph Weber-Lopez, MD

• Social Worker in Huntington, NY
• Providers in Huntington, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.