Organization Active NPI

Mella Clancy-Schifilliti LCSW PC

  • Clinical Social Worker
  • Syosset, NY
National Provider Identifier
1639749153
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MELLA CLANCY-SCHIFILLITI LCSW PC
Practice address
6800 Jericho Tpke Ste 120W
Syosset, NY 11791-4445
Phone
(917) 940-9980
NPI assigned
Jun 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Mella Clancy-SchifillitiNPI 1033480744
Title
LCSW
Phone
(917) 940-9980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6800 Jericho Tpke Ste 120W
Syosset, NY 11791-4445

Mailing address

4230 Douglaston Pkwy Apt 3H
Douglaston, NY 11363-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210720000517 NY Part B Supplier - Clinic/Group Practice 1759784424 Receives reassigned benefits from 1 practitioner
Practice locations: Syosset, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1639749153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 DOUGLASTON PKWY APT 3H",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 JERICHO TPKE STE 120W",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914445",
            "telephone_number": "917-940-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLA CLANCY-SCHIFILLITI LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "CLANCY-SCHIFILLITI",
        "authorized_official_first_name": "MELLA",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "917-940-9980"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.