Individual provider Active NPI

Theresa Nicole Elie, LCSW

  • Clinical Social Worker
  • Orchard Park, NY
National Provider Identifier
1780085605
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090488 Issued in NY
Practice address
227 Thorn Ave
Orchard Park, NY 14127-2600
Phone
(716) 882-4357
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 090488 NY Primary
Clinical Social Worker 1041C0700X 092333 NY

Addresses

Primary practice location

227 Thorn Ave
Orchard Park, NY 14127-2600

Mailing address

227 Thorn Ave
Orchard Park, NY 14127-2600
Phone (716) 662-2040

Other names 1

  • Miss Theresa Nicole Richir Former name

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
I20220620000320 NY Practitioner - Clinical Social Worker 6204215445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
092333NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County South East Corp V CurrentSince Mar 8, 2022 Accepting new patients

Locations

2040 Seneca St
Buffalo, NY 14210
Phone (716) 828-0560

1280 Main St
Buffalo, NY 14209
Phone (716) 832-1251

227 Thorn Ave
Orchard Park, NY 14127
Phone (716) 539-6737

Organizations & group practices 1

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": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1780085605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 THORN AVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272600",
            "telephone_number": "716-662-2040",
            "fax_number": "716-662-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 THORN AVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272600",
            "telephone_number": "716-882-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIE",
        "first_name": "THERESA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090488",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "RICHIR",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.