Individual provider Active NPI

Erica R Abramov

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1255761763
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092366 Issued in NY
Practice address
135 Madison Ave
New York, NY 10016-6712
Phone
(609) 836-0077
NPI assigned
Nov 19, 2013
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 092366 NY Primary

Addresses

Primary practice location

135 Madison Ave
New York, NY 10016-6712

Mailing address

21 Pecan Valley Dr.
Marlboro, NJ 07746-2185
Phone (917) 418-7796

Other practice location 1

77 Chicago Ave
Staten Island, NY 10305-3757
Phone (917) 418-7796

Other practice location 2

216 E 47th St Ste 9
New York, NY 10017-2185
Phone (609) 836-0077

Other practice location 3

2015 Shore Parkway
Apt. 11G
Brooklyn, NY 11214
Phone (609) 836-0077

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
092366NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Extending Roots LCSW PC Clinical CurrentSince Mar 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1255761763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PECAN VALLEY DR.",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462185",
            "telephone_number": "917-418-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166712",
            "telephone_number": "609-836-0077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053757",
            "country_code": "US",
            "telephone_number": "917-418-7796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 E 47th St Ste 9",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100172185",
            "country_code": "US",
            "telephone_number": "609-836-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2015 Shore Parkway",
            "address_2": "Apt. 11G",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11214",
            "country_code": "US",
            "telephone_number": "609-836-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAMOV",
        "first_name": "ERICA R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.