Individual provider Active NPI

Yetta R Zelikovitz, LCSW

  • Clinical Social Worker
  • Lakewood, NJ
National Provider Identifier
1427214345
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05817000 Issued in NJ
Practice address
279 Van Buren Ave N
Lakewood, NJ 08701-2357
Phone
(732) 886-7518
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X RO29656-1 NY
Clinical Social Worker 1041C0700X 44SC05817000 NJ Primary

Addresses

Primary practice location

279 Van Buren Ave N
Lakewood, NJ 08701-2357

Mailing address

279 Van Buren Ave N
Lakewood, NJ 08701-2357
Phone (732) 886-7518

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05817000NJMDClinical Social Worker
RO29656-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1427214345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 VAN BUREN AVE N",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012357",
            "telephone_number": "732-886-7518",
            "fax_number": "732-886-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 VAN BUREN AVE N",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012357",
            "telephone_number": "732-886-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELIKOVITZ",
        "first_name": "YETTA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO29656-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05817000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.