Individual provider Active NPI

Liana Efstratiadis, CSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1881631141
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
062091-1 Issued in NY
Practice address
501 5TH Ave
Suite 1709
New York, NY 10017-6129
Phone
(718) 207-0006
NPI assigned
Jun 2, 2006
Last updated
Aug 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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 062091-1 NY Primary

Addresses

Primary practice location

501 5TH Ave
Suite 1709
New York, NY 10017-6129

Mailing address

1814 21St Dr
Astoria, NY 11105-3936
Phone (718) 207-0006

Other identifiers 1

IdentifierTypeStateIssuer
062091-1OtherNYSTATE LICENSE

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
I20110817000455 NY Practitioner - Clinical Social Worker 4082883590 Practice locations: Astoria, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

501 5TH Ave
RM 1709
New York, NY 10017-6129
Phone (718) 207-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062091-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1881631141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 21ST DR",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111053936",
            "telephone_number": "718-207-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE",
            "address_2": "SUITE 1709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176129",
            "telephone_number": "718-207-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFSTRATIADIS",
        "first_name": "LIANA",
        "name_prefix": "Miss",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "062091-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "062091-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.