Individual provider Active NPI

Doris Emma Ullendorff, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1346950680
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R032513-1 Issued in NY
Practice address
318 W 108TH St
New York, NY 10025-2772
Phone
(646) 596-7506
NPI assigned
Nov 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 R032513-1 NY Primary

Addresses

Primary practice location

318 W 108TH St
New York, NY 10025-2772

Mailing address

875 W End Ave Apt 7B
New York, NY 10025-4952
Phone (212) 877-9644

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL commonsensetherapy.com Direct

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
R032513-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1346950680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 W END AVE APT 7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100254952",
            "telephone_number": "212-877-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 W 108TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252772",
            "telephone_number": "646-596-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLENDORFF",
        "first_name": "DORIS",
        "middle_name": "EMMA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R032513-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "commonsensetherapy.com",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "318 W 108th St Apt 1",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100252772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 28, 2022; 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.