Individual provider Active NPI

Zeva Adler Citronenbaum, LCSWR

  • Clinical Social Worker
  • Monsey, NY
National Provider Identifier
1497995468
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069590-1 Issued in NY
Practice address
11 Jay CT
Monsey, NY 10952-1627
Phone
(914) 646-3164
NPI assigned
Mar 3, 2009
Last updated
Mar 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X AZ
Clinical Social Worker 1041C0700X R069590-1 NY Primary

Addresses

Primary practice location

11 Jay CT
Monsey, NY 10952-1627

Mailing address

1581 Route 202 # 105
Pomona, NY 10970-2901
Phone (914) 646-3164

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
I20090518000017 NY Practitioner - Clinical Social Worker 7416006747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr J Stern Psychological Services PCGroup PAC ID 3274906953, 5 clinicians

Practice addresses (Care Compare)

6007 19TH Ave
Brooklyn, NY 11204-2337
Phone (718) 234-2506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R069590-1NYMDClinical Social Worker
034291-1NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr J Stern Psychological Services PC CurrentSince Oct 11, 2023 Accepting new patients
Creative Boundaries LLC Clinical CurrentSince May 16, 2021 Accepting new patients
Shine Medical PC Past Accepting new patients

Locations

5417 18th Ave
Brooklyn, NY 11204
Phone (718) 234-2506

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1497995468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 ROUTE 202 # 105",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702901",
            "telephone_number": "914-646-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JAY CT",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521627",
            "telephone_number": "914-646-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRONENBAUM",
        "first_name": "ZEVA",
        "middle_name": "ADLER",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069590-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.