Organization Active NPI

Erica Zeller Licensed Clinical Social Work PLLC

  • Clinical Social Worker
  • Smithtown, NY
National Provider Identifier
1992217871
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085957 Issued in NY
Legal business name
ERICA ZELLER LICENSED CLINICAL SOCIAL WORK PLLC
Practice address
15 Bellemeade Ave Ste 3
Smithtown, NY 11787
Phone
(631) 863-9223
Fax
(631) 406-6444
NPI assigned
Oct 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Erica Zeller, LCSW
Title
Owner
Phone
(631) 863-9223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 085957 NY Primary

Addresses

Primary practice location

15 Bellemeade Ave Ste 3
Smithtown, NY 11787

Mailing address

25 Route 111 Unit 1210
Smithtown, NY 11787-7049
Phone (631) 863-9223

National Provider Directory

National Provider Directory

Locations

25 Route 111
Unit 1210
Smithtown, NY 11787

15 Bellemeade Ave
Ste 3
Smithtown, NY 11787
Phone (631) 863-9223

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1992217871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROUTE 111 UNIT 1210",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117877049",
            "telephone_number": "631-863-9223",
            "fax_number": "631-406-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BELLEMEADE AVE STE 3",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-863-9223",
            "fax_number": "631-406-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA ZELLER LICENSED CLINICAL SOCIAL WORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "ZELLER",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-863-9223",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.