Individual provider Active NPI

Yuliya M Nisonova, LMSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1831489178
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087727 Issued in NY
Practice address
2792 Ocean Ave FL 6
Brooklyn, NY 11229-4730
Phone
(718) 332-5268
NPI assigned
Apr 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 082978-1 NY
Developmentally Disabled Services Day Training Agency 251C00000X 087727 NY
Clinical Social Worker 1041C0700X 087727 NY Primary

Addresses

Primary practice location

2792 Ocean Ave FL 6
Brooklyn, NY 11229-4730

Mailing address

1305 E 18TH St
# A1
Brooklyn, NY 11230-5343
Phone (718) 564-4989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082978-1NYMDSocial Worker
087727NYMDDevelopmentally Disabled Services Day Training Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince May 17, 2021 Accepting new patients
Young Adult Institute, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Premier Healthcare, Inc. Current Accepting new patients
Skills Nyc Incorporated Clinical Current Accepting new patients
Kings Physician Services, PC Past Accepting new patients
Park Slope Medical Service PC Past Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

Organizations & group practices 6

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1831489178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 E 18TH ST",
            "address_2": "# A1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305343",
            "telephone_number": "718-564-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2792 OCEAN AVE FL 6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294730",
            "telephone_number": "718-332-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISONOVA",
        "first_name": "YULIYA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "082978-1",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "087727",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.