Individual provider Active NPI

Elysa Lois Lebron, L.C.S.W.

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1447678461
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO72270-1 Issued in NY
Practice address
29 Barstow Rd
Suite 106
Great Neck, NY 11021-2222
Phone
(516) 384-6470
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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 RO72270-1 NY Primary

Addresses

Primary practice location

29 Barstow Rd
Suite 106
Great Neck, NY 11021-2222

Mailing address

29 Barstow Rd
Suite 106
Great Neck, NY 11021-2222
Phone (516) 384-6470

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RO72270-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1447678461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "SUITE 106",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212222",
            "telephone_number": "516-384-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "SUITE 106",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212222",
            "telephone_number": "516-384-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRON",
        "first_name": "ELYSA",
        "middle_name": "LOIS",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO72270-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.