Individual provider Active NPI

Elizabeth J Kolb, LCSW

  • Clinical Social Worker
  • Sleepy Hollow, NY
National Provider Identifier
1437282225
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
072758 Issued in NY
Practice address
245 N Broadway Ste 203
Sleepy Hollow, NY 10591
Phone
(917) 754-1912
Fax
(914) 332-7253
NPI assigned
Mar 13, 2007
Last updated
May 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072758 NY Primary

Addresses

Primary practice location

245 N Broadway Ste 203
Sleepy Hollow, NY 10591

Mailing address

245 N Broadway Ste 203
Sleepy Hollow, NY 10591-2657
Phone (917) 754-1912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040514000330 NY Practitioner - Clinical Social Worker 9234129982 Practice locations: Sleepy Hollow, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

245 N Broadway
Suite 203
Sleepy Hollow, NY 10591-2657
Phone (917) 754-1912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072758NYMDPharmacist

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1437282225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N BROADWAY STE 203",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912657",
            "telephone_number": "917-754-1912",
            "fax_number": "914-332-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N BROADWAY STE 203",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "10591",
            "telephone_number": "917-754-1912",
            "fax_number": "914-332-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.