Rebecca Elliott

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

026955-01 Issued in NY

Practice address

733 3Rd Ave
New York, NY 10017-3204

Phone

(646) 450-3064

NPI assigned

Dec 25, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Northeast Psychological Wellness, PLLC

  • Psychologist
  • New York, NY
  • NPI 1306408513
  NPD

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

{
    "created_epoch": "1703462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1275302838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173204",
            "telephone_number": "646-450-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-25",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "026955-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Cordelia Elliott, M.D.
• Fitzroy Anthony Elliott, MD
• Jennifer Elliott, LMSW
• Kaaren Elliott
• Nerik Elliott, PMHNP-BC, RN
• Shayquana Elliott
• Stephen Mark Elliott, LCSW
• Vanessa Elliott
• Ellis Consulting Inc.
• Jahanna Raphine Ellis Russell, M.B.B.S

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.