Individual provider Active NPI

Roua Eltayeib, LMFT

  • Marriage & Family Therapist
  • Kew Gardens, NY
National Provider Identifier
1740881101
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
002131 Issued in NY
Practice address
8057 Lefferts Blvd Apt 3
Kew Gardens, NY 11415-1797
Phone
(631) 450-2295
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 002131 NY Primary
Marriage & Family Therapist 106H00000X 37FI00221200 NJ

Addresses

Primary practice location

8057 Lefferts Blvd Apt 3
Kew Gardens, NY 11415-1797

Mailing address

8057 Lefferts Blvd Apt 3
Kew Gardens, NY 11415-1797
Phone (347) 706-5538

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
37FI00221200NJMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1740881101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8057 LEFFERTS BLVD APT 3",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151797",
            "telephone_number": "347-706-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8057 LEFFERTS BLVD APT 3",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151797",
            "telephone_number": "631-450-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTAYEIB",
        "first_name": "ROUA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "002131",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37FI00221200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.