Individual provider Active NPI

Melissa Dawn Elliott-Brogan, LCSW

  • Clinical Social Worker
  • West Sayville, NY
National Provider Identifier
1720352164
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082182 Issued in NY
Practice address
93 Main St
Suite 1J
West Sayville, NY 11796-1832
Phone
(631) 509-2575
Fax
(631) 256-9353
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082182 NY Primary

Addresses

Primary practice location

93 Main St
Suite 1J
West Sayville, NY 11796-1832

Mailing address

PO Box 822
Sayville, NY 11782-0822
Phone (631) 509-2575

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
I20160217001936 NY Practitioner - Clinical Social Worker 3779888474 Reassigns benefits to 1 organization
Practice locations: West Sayville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

93 Main St
Suite 1J
West Sayville, NY 11796-1832
Phone (631) 502-5220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082182NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Innovations Counseling, LCSW PLLC Clinical CurrentSince Sep 13, 2024 Accepting new patients
Sardonyx Wellness LCSW PLLC Clinical CurrentSince Sep 13, 2024 Accepting new patients

Locations

93 Main St
Ste 1J
West Sayville, NY 11796
Phone (631) 502-5220

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1720352164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117820822",
            "telephone_number": "631-509-2575",
            "fax_number": "631-256-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 MAIN ST",
            "address_2": "SUITE 1J",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961832",
            "telephone_number": "631-509-2575",
            "fax_number": "631-256-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT-BROGAN",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sayville, NY

Sources for this page

Verify at the official NPI Registry.