NPIMap

Organization Active NPI

Brooklyn Psychotherapy Services LCSW PLLC

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1396102612
Registry record updated Jan 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR062278-1 Issued in NY
Legal business name
BROOKLYN PSYCHOTHERAPY SERVICES LCSW PLLC
Practice address
3380 Nostrand Ave Apt 1E
Suite 1E
Brooklyn, NY 11229-4032
Phone
(917) 674-9522
NPI assigned
Jan 16, 2016
Last updated
Jan 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yelena Zhuklevich, LCSWNPI 1831298249
Title
Owner
Phone
(917) 674-9522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR062278-1 NY Primary

Addresses

Primary practice location

3380 Nostrand Ave Apt 1E
Suite 1E
Brooklyn, NY 11229-4032

Mailing address

354 Van Sicklen St
Brooklyn, NY 11223-3867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160331000439 NY Part B Supplier - Clinic/Group Practice 1153628490 Receives reassigned benefits from 7 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1452902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452902400000",
    "number": "1396102612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 VAN SICKLEN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 NOSTRAND AVE APT 1E",
            "address_2": "SUITE 1E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294032",
            "telephone_number": "917-674-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN PSYCHOTHERAPY SERVICES LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-16",
        "last_updated": "2016-01-16",
        "status": "A",
        "authorized_official_last_name": "ZHUKLEVICH",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-674-9522",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR062278-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.