Active NPI
Yolanda Koumidou-Vlesmas, LCSW
- Clinical Social Worker
- Lynbrook, NY
National Provider Identifier
1366501421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R033265
- Practice address
- 150 Piccadilly DWNS
Lynbrook, NY 11563-3114 - Phone
- (516) 568-0306
- Fax
- (516) 568-0009
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- 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 | R033265 | NY | Primary |
Addresses
Primary practice location
150 Piccadilly DWNS
Lynbrook, NY 11563-3114
Mailing address
150 Piccadilly DWNS
Lynbrook, NY 11563-3114
Phone (516) 568-0306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2025 through Feb 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R033265 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366501421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 PICCADILLY DWNS",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115633114",
"telephone_number": "516-568-0306",
"fax_number": "516-568-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 PICCADILLY DWNS",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115633114",
"telephone_number": "516-568-0306",
"fax_number": "516-568-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUMIDOU-VLESMAS",
"first_name": "YOLANDA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R033265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.