Individual provider Active NPI

Estelle Lewis, LCSW-R

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1811099393
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R040752-1 Issued in NY
Practice address
2744 Hylan Blvd # 171
Staten Island, NY 10306-4658
Phone
(917) 916-9910
Fax
(518) 677-1803
NPI assigned
Sep 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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 R040752-1 NY Primary

Addresses

Primary practice location

2744 Hylan Blvd # 171
Staten Island, NY 10306-4658

Mailing address

2744 Hylan Blvd # 171
Staten Island, NY 10306-4658
Phone (718) 500-4919

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
I20040811000436 NY Practitioner - Clinical Social Worker 0042292724 Reassigns benefits to 1 organization
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040752-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pakier Psychological Services P.C. CurrentSince Feb 9, 2020 Accepting new patients
Estelle Lewis LCSW Enterprises PLLC Clinical CurrentSince Sep 26, 2022 Accepting new patients
Heartland Medical Services, P.C. Past Accepting new patients

Locations

2744 Hylan Blvd
Staten Island, NY 10306
Phone (917) 916-9910

1550 Richmond Ave
Ste 203
Staten Island, NY 10314
Phone (718) 370-1250

Organizations & group practices 3

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": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1811099393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2744 HYLAN BLVD # 171",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064658",
            "telephone_number": "718-500-4919",
            "fax_number": "518-677-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 HYLAN BLVD # 171",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064658",
            "telephone_number": "917-916-9910",
            "fax_number": "518-677-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ESTELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040752-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.