Individual provider Active NPI

Elizabeth R Mayer, LCSW MSW

  • Psychoanalysis Psychologist
  • Bronx, NY
National Provider Identifier
1770661654
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
License
047952R Issued in NY
Practice address
3736 Henry Hudson Pkwy
Suite 207
Bronx, NY 10463-1502
Phone
(718) 543-1262
NPI assigned
Nov 1, 2006
Last updated
Oct 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalysis Psychologist 103TP0814X 047952R NY Primary

Addresses

Primary practice location

3736 Henry Hudson Pkwy
Suite 207
Bronx, NY 10463-1502

Mailing address

4555 Henry Hudson Parkway
Apt 1410
Bronx, NY 10471
Phone (646) 474-7169

Other identifiers 2

IdentifierTypeStateIssuer
213592357OtherNYUBH
739440OtherNYAETNA

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
I20210928002052 NY Practitioner - Clinical Social Worker 3375940760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

135 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047952RNYMDPsychoanalysis Psychologist
047952NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC CurrentSince Aug 1, 2021 Accepting new patients
Knapp Street Psychiatry, PC CurrentSince Aug 1, 2021 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 420-1934

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1770661654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 HENRY HUDSON PARKWAY",
            "address_2": "APT 1410",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10471",
            "telephone_number": "646-474-7169",
            "fax_number": "718-796-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3736 HENRY HUDSON PKWY",
            "address_2": "SUITE 207",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631502",
            "telephone_number": "718-543-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "047952R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "213592357",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "739440",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.