Active NPI
Elliot Bardavid, LCSW
- Clinical Social Worker
- Bayside, NY
National Provider Identifier
1285878041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 018951-1
- Practice address
- 20939 23Rd Ave
Suite 6a
Bayside, NY 11360-1844 - Phone
- (917) 767-7604
- NPI assigned
- Apr 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 018951-1 | NY | Primary |
Addresses
Primary practice location
20939 23Rd Ave
Suite 6a
Bayside, NY 11360-1844
Mailing address
20939 23Rd Ave
Suite 6a
Bayside, NY 11360-1844
Phone (917) 767-7604
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018951 | NY | MD | Orthopedic Physical Therapist |
| 018951-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240444800000",
"number": "1285878041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20939 23RD AVE",
"address_2": "SUITE 6A",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601844",
"telephone_number": "917-767-7604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20939 23RD AVE",
"address_2": "SUITE 6A",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601844",
"telephone_number": "917-767-7604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDAVID",
"first_name": "ELLIOT",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-23",
"last_updated": "2009-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "018951-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.