Individual provider Active NPI

Elyssa Jodi Yoos, LCSW

  • Clinical Social Worker
  • Commack, NY
National Provider Identifier
1891883336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR056396-1 Issued in NY
Practice address
645 Commack Rd
Suite #3
Commack, NY 11725-5401
Phone
(631) 543-8877
Fax
(631) 543-8886
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PR056396-1 NY Primary

Addresses

Primary practice location

645 Commack Rd
Suite #3
Commack, NY 11725-5401

Mailing address

47 Morewood Dr
Smithtown, NY 11787-2341
Phone (631) 366-0530

Other names 1

  • Miss Elyssa Jodi Krieger Former name

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
PR056396-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Counseling LCSW PLLC Clinical Past Accepting new patients

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891883336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MOREWOOD DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872341",
            "telephone_number": "631-366-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 COMMACK RD",
            "address_2": "SUITE #3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255401",
            "telephone_number": "631-543-8877",
            "fax_number": "631-543-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOOS",
        "first_name": "ELYSSA",
        "middle_name": "JODI",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR056396-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSSA",
            "last_name": "KRIEGER",
            "middle_name": "JODI",
            "prefix": "MISS",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.