Jewish Board of Family and Children Services

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

License

071-000-1 Issued in NY

Legal business name

JEWISH BOARD OF FAMILY AND CHILDREN SERVICES

Practice address

Jewish Board and Children and Family Services
Pride of Judea Community Services (Clinic)
Douglaston, NY 11362

Phone

(718) 423-6200

Fax

(718) 423-9762

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Sue Gellis, LCSW

Title

Licenced Clinical Social Worker

Phone

(718) 961-3521

Specialties & licenses 1

Addresses

Other names 1

• Pride of Judea Other name

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689758955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43-06 159TH STREET,",
            "address_2": "B4",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11358",
            "telephone_number": "718-423-6200",
            "fax_number": "718-423-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JEWISH BOARD AND CHILDREN AND FAMILY SERVICES",
            "address_2": "PRIDE OF JUDEA COMMUNITY SERVICES (CLINIC)",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "11362",
            "telephone_number": "718-423-6200",
            "fax_number": "718-423-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH BOARD OF FAMILY AND CHILDREN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GELLIS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "LICENCED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "718-961-3521",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NY",
            "license": "071-000-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride of Judea",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Huang
• Lisa Maria Ieraci, M.A, LCAT
• Ekaterina Ignatov
• Katia Isasi
• Jalana Shereese, LCSW, PLLC (Jalana Shereese)
• Sandra Jimenez, DNP, ANP-BC, RN
• David Shalom Kadosh, MD
• Justine Kang
• Angelica I Khaimov, LMSW
• In Ho Kim, L.AC

• PACE Provider Organization in Douglaston, NY
• Providers in Douglaston, NY by specialty
• PACE Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.