Active NPI
Christopher Eldredge, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1629576475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R033093
- Practice address
- 52 Riverside Drive, Suite 1a
New York, NY 10024 - Phone
- (212) 877-7318
- NPI assigned
- Jan 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R033093 | NY | Primary |
Addresses
Primary practice location
52 Riverside Drive, Suite 1a
New York, NY 10024
Mailing address
52 Riverside Drive, Suite 1a
New York, NY 10024
Phone (212) 877-7318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 30, 2015 through Oct 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R033093 | NY | MD | Clinical Social Worker |
| 033093 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629576475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 RIVERSIDE DRIVE, SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10024",
"telephone_number": "212-877-7318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 RIVERSIDE DRIVE, SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10024",
"telephone_number": "212-877-7318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDREDGE",
"first_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R033093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.