Nellie E. Liciaga, LCSW, M-CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12366 Issued in NY

Practice address

9729 64TH Rd
Rego Park, NY 11374-2259

Phone

(718) 896-3400

NPI assigned

May 12, 2008

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 identifiers 1

Other names 1

• Elaine Lederer Professional name

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

Specialty

Clinical Social Worker

Education

Fordham University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Long Island Consultation Center IncGroup PAC ID 8729068622, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Long Island Consultation Center, Inc.

  • Clinical Social Worker
  • Elmhurst, NY
  • NPI 1295878577

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• N.L. Psychotherapy Services LCSW PC

  • Mental Health Counselor
  • Bronx, NY
  • NPI 1265384689
  NPD Authorized official
• Long Island Consultation Center

  • Counselor
  • Elmhurst, NY
  • NPI 1356016703
  NPD

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1437326253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 142ND ST APT 4A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542156",
            "telephone_number": "347-256-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9729 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742259",
            "telephone_number": "718-896-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICIAGA",
        "first_name": "NELLIE",
        "middle_name": "E.",
        "credential": "LCSW, M-CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "12366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "LEDERER",
            "credential": "EXECUTIVE DIRECTOR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Celia Liang, DO
• Steven Lieberman, OD, FAAO, PC
• Life Medical Supply Inc.
• Lifeskills Preshool Program
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• Lilia B Idanan Physician, PC

• Addiction (Substance Use Disorder) Counselor in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.