Elena Issendorf, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083549 Issued in NY

Practice address

516 W 47TH Street
New York, NY 10036

Phone

(917) 650-6325

NPI assigned

Jan 12, 2012

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

Other names 1

• Elena Krotova Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1376814913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W 47TH STR. APT N7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362978",
            "telephone_number": "917-650-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W 47TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10036",
            "telephone_number": "917-650-6325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4116 149th St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113551008",
            "country_code": "US",
            "telephone_number": "718-539-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSENDORF",
        "first_name": "ELENA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KROTOVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua P Issack, MD, MPH
• Abdul-Haki Issah, M.D.
• Sudi Issak
• Amina Issaka
• Melineh Issayans
• Hassida Sida Isserman
• Devora Isseroff, MD
• Lauren Isserow
• Talha Can Issevenler
• Steven Issley, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.

Verify at the official NPI Registry.