Eb Licensed Clinical Social Work Services, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EB LICENSED CLINICAL SOCIAL WORK SERVICES, PLLC

Practice address

65 Froehlich Farm Blvd # 812W
Woodbury, NY 11797-2926

Phone

(516) 587-4312

NPI assigned

Aug 29, 2024

Organization subpart

No

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

Authorized official

Name

Sing Kit Keith ChanNPI 1619047313

Title

Manager

Phone

(917) 304-9203

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emnine Lefevre, LCSW

  • Clinical Social Worker
  • Middletown, NY
  • NPI 1538726526
  Medicare reassignment NPD
• Sing Kit Keith Chan, MPT

  • Physical Therapist
  • New York, NY
  • NPI 1619047313
  NPD Authorized official
• Elie Berdy, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1518346287
  NPD
• Dominic Ambrosio, LMSW

  • Case Manager/Care Coordinator
  • Hicksville, NY
  • NPI 1962175810
  NPD (past)
• Uyinoma James Inneh, LMSW

  • Social Worker
  • Woodbury, NY
  • NPI 1346137056
  NPD (past)
• Jeffrey S Sider, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Woodbury, NY
  • NPI 1770642530
  NPD (past)

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1407680648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 REDMONT RD",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523025",
            "telephone_number": "516-587-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 FROEHLICH FARM BLVD # 812W",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972926",
            "telephone_number": "516-587-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EB LICENSED CLINICAL SOCIAL WORK SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "SING KIT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-304-9203"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Ashley Boccio DPM, PLLC
• Dr. Karen Schwartz MD PC
• DRS. Ritter-Kahn and Schildhaus, DMD PC
• Theodore Michael Dubinsky, L.C.S.W.
• Lauren Michelle Durante, NP
• Education-Relief, Inc.
• Bruce L Edwards, MD
• Douglas Lawrence Egan, PH.D.
• Kerry Ellen Egan, SLPD, CCC-SLP
• David Ehrlich

• Mental Health Clinic/Center (Including Community Mental Health Center) in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.