Individual provider Active NPI

Elaine Pamela Becker, LMSW

  • Clinical Social Worker
  • Brentwood, NY
National Provider Identifier
1275852774
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0698471 Issued in NY
Practice address
998 Crooked Hill Rd
Western Suffolk Center BLDG 56
Brentwood, NY 11717-1019
Phone
(631) 761-2177
Fax
(631) 761-3388
NPI assigned
May 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2010

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 0698471 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Western Suffolk Center BLDG 56
Brentwood, NY 11717-1019

Mailing address

998 Crooked Hill Rd
Western Suffolk Center BLDG 56
Brentwood, NY 11717-1019
Phone (631) 761-2177

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
I20190916002294 NY Order and Referring Only - Clinical Social Worker 9133458235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0698471NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1275852774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "WESTERN SUFFOLK CENTER BLDG 56",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-2177",
            "fax_number": "631-761-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "address_2": "WESTERN SUFFOLK CENTER BLDG 56",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-2177",
            "fax_number": "631-761-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "ELAINE",
        "middle_name": "PAMELA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0698471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.