Individual provider Active NPI

Stavros Efstratios Delardas, LCSW, PMH-C, CLC

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1679227771
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103322 Issued in NY
Practice address
192 Holden Blvd
Staten Island, NY 10314-5159
Phone
(718) 290-5937
NPI assigned
Feb 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 112496 NY
Clinical Social Worker 1041C0700X 103322 NY Primary

Addresses

Primary practice location

192 Holden Blvd
Staten Island, NY 10314-5159

Mailing address

192 Holden Blvd
Staten Island, NY 10314-5159
Phone (718) 290-5937

Other practice location 1

235 Port Richmond Ave
Staten Island, NY 10302-1701
Phone (718) 876-1732 ext. 7519

Other practice location 2

135 Canal St
Staten Island, NY 10304-2273
Phone (718) 876-1732

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
112496NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1679227771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 HOLDEN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145159",
            "telephone_number": "718-290-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 HOLDEN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145159",
            "telephone_number": "718-290-5937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Port Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103021701",
            "country_code": "US",
            "telephone_number": "718-876-1732 x7519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 Canal St",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103042273",
            "country_code": "US",
            "telephone_number": "718-876-1732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELARDAS",
        "first_name": "STAVROS",
        "middle_name": "EFSTRATIOS",
        "credential": "LCSW, PMH-C, CLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112496",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.