Individual provider Active NPI

Elisheva Laks, LMSW

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1831738731
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
107079 Issued in NY
Practice address
11020 71St Rd
Forest Hills, NY 11375-4914
Phone
(718) 793-3133
Fax
(718) 793-2023
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 107079 NY Primary

Addresses

Primary practice location

11020 71St Rd
Forest Hills, NY 11375-4914

Mailing address

7159 168TH St
Flushing, NY 11365-3241
Phone (646) 383-3009

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
107079NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1831738731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7159 168TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113653241",
            "telephone_number": "646-383-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 71ST RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754914",
            "telephone_number": "718-793-3133",
            "fax_number": "718-793-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKS",
        "first_name": "ELISHEVA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.