| Long Island Consultation Center, Inc. | |
|
9131 Queens Blvd Ste 222 Elmhurst NY 11373-5511 | |
| (718) 896-3400 | |
| (718) 459-5621 |
| Full Name | Long Island Consultation Center, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 9131 Queens Blvd Ste 222, Elmhurst, New York |
| Authorized Official Name and Position | Elaine Lederer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7188963400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Island Consultation Center, Inc. 9131 Queens Blvd Ste 222 Elmhurst NY 11373-5511 Ph: (718) 896-3400 | Long Island Consultation Center, Inc. 9131 Queens Blvd Ste 222 Elmhurst NY 11373-5511 Ph: (718) 896-3400 |
| NPI Number | 1295878577 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 11/02/2016 |
| Medicare PECOS PAC ID | 8729068622 |
|---|---|
| Medicare Enrollment ID | O20040721001568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295878577 | NPI | - | NPPES |
| 00244019 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 090210852 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6715100A (New York) | Primary |
| Provider Name | Yevgeniy Khaldarov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710932926 PECOS PAC ID: 3476530734 Enrollment ID: I20040702001295 |
| Provider Name | Phyllis Hyatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104902733 PECOS PAC ID: 1759357908 Enrollment ID: I20040908001396 |
| Provider Name | Nancy Tartakoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871870410 PECOS PAC ID: 7810952199 Enrollment ID: I20041129000440 |
| Provider Name | Cheryl B Silver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740351576 PECOS PAC ID: 5092770180 Enrollment ID: I20041201000019 |
| Provider Name | Gail Copeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336212018 PECOS PAC ID: 7214981778 Enrollment ID: I20050308000491 |
| Provider Name | Hasina A Haroon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053345223 PECOS PAC ID: 8426082553 Enrollment ID: I20050919000895 |
| Provider Name | Caroline Blakely |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568647931 PECOS PAC ID: 1557386026 Enrollment ID: I20051013000467 |
| Provider Name | Usha K Tandon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487691820 PECOS PAC ID: 9032120126 Enrollment ID: I20060607000041 |
| Provider Name | Carl J Rosenmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285673376 PECOS PAC ID: 1759392848 Enrollment ID: I20060607000051 |
| Provider Name | Thomas J Joyce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831256841 PECOS PAC ID: 2062512205 Enrollment ID: I20070717000392 |
| Provider Name | Shelia G Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982762910 PECOS PAC ID: 2961593983 Enrollment ID: I20070806000631 |
| Provider Name | Gila Brenner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235202581 PECOS PAC ID: 3476622705 Enrollment ID: I20080513000339 |
| Provider Name | Karl Dormesy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417033184 PECOS PAC ID: 1456426576 Enrollment ID: I20080823000034 |
| Provider Name | Joanne Iorio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790968857 PECOS PAC ID: 5698824068 Enrollment ID: I20090514000562 |
| Provider Name | Ulyana Khaldarov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366580367 PECOS PAC ID: 0648337840 Enrollment ID: I20090609000429 |
| Provider Name | Elaine Solomon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912134396 PECOS PAC ID: 2062556988 Enrollment ID: I20100216000598 |
| Provider Name | Melanie Anne Maclennan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619176955 PECOS PAC ID: 0840357448 Enrollment ID: I20100329000642 |
| Provider Name | Marlene Smikle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255417903 PECOS PAC ID: 2567650831 Enrollment ID: I20101230000811 |
| Provider Name | David Ackerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376572750 PECOS PAC ID: 0446449896 Enrollment ID: I20110115000021 |
| Provider Name | Geri L Lacks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497786776 PECOS PAC ID: 3274705462 Enrollment ID: I20111012000418 |
| Provider Name | Anita E La Rosa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003054644 PECOS PAC ID: 1850564170 Enrollment ID: I20111102000517 |
| Provider Name | Edward Creighton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982999363 PECOS PAC ID: 7618138975 Enrollment ID: I20120412000444 |
| Provider Name | Sherry A Amatenstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275790420 PECOS PAC ID: 2860641263 Enrollment ID: I20120928000322 |
| Provider Name | Miriam Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811141377 PECOS PAC ID: 0446400972 Enrollment ID: I20121018000573 |
| Provider Name | Erika Goldstein Steuerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043381890 PECOS PAC ID: 5092965350 Enrollment ID: I20121022000573 |
| Provider Name | Poonam B Dharni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750428413 PECOS PAC ID: 0446401608 Enrollment ID: I20121115000535 |
| Provider Name | Alan Stearns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497994081 PECOS PAC ID: 1355576729 Enrollment ID: I20131022000040 |
| Provider Name | Shantie Schwarte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720228604 PECOS PAC ID: 4789819459 Enrollment ID: I20131105001314 |
| Provider Name | Carrol Bissoondial |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699005553 PECOS PAC ID: 1355565300 Enrollment ID: I20140612000777 |
| Provider Name | Weerasinghege Jayasekara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558774653 PECOS PAC ID: 6800018516 Enrollment ID: I20141113001383 |
| Provider Name | Joseph Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801039870 PECOS PAC ID: 7113229014 Enrollment ID: I20160108002545 |
| Provider Name | Robert Grabowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447316740 PECOS PAC ID: 5890099253 Enrollment ID: I20160204000773 |
| Provider Name | Altagracia Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760721088 PECOS PAC ID: 3072891381 Enrollment ID: I20161020001052 |
| Provider Name | Lisa Vera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427501188 PECOS PAC ID: 4789963174 Enrollment ID: I20161107001679 |
| Provider Name | Mary A Wolford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538460142 PECOS PAC ID: 7315228152 Enrollment ID: I20170110000969 |
| Provider Name | Iulian Constantin Ungureanu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568905263 PECOS PAC ID: 9436418795 Enrollment ID: I20180706000364 |
| Provider Name | Darcy Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720412620 PECOS PAC ID: 9335483379 Enrollment ID: I20181203002039 |
| Provider Name | Christina Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275031072 PECOS PAC ID: 4183950918 Enrollment ID: I20190731001764 |
| Provider Name | David S Lesser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700324449 PECOS PAC ID: 8325377039 Enrollment ID: I20190905002027 |
| Provider Name | Melissa M Crecca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194198689 PECOS PAC ID: 9234565706 Enrollment ID: I20200130003083 |
| Provider Name | William G Naranjo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427156157 PECOS PAC ID: 2769607688 Enrollment ID: I20200218002049 |
| Provider Name | Sarah Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265931976 PECOS PAC ID: 3072925296 Enrollment ID: I20201212000054 |
| Provider Name | Debra J Washington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225353931 PECOS PAC ID: 0042622003 Enrollment ID: I20201215003166 |
| Provider Name | Richard A Groll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255838199 PECOS PAC ID: 1456758473 Enrollment ID: I20210917001508 |
| Provider Name | David T Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194071787 PECOS PAC ID: 6305231788 Enrollment ID: I20220322000881 |
| Provider Name | Gianpaul Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831672914 PECOS PAC ID: 3779966072 Enrollment ID: I20220819000419 |
| Provider Name | Shaqueen Walcott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881092286 PECOS PAC ID: 5799151064 Enrollment ID: I20221012001749 |
| Provider Name | Nellie E Liciaga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437326253 PECOS PAC ID: 5294101051 Enrollment ID: I20221019001063 |
| Provider Name | Steven Rothman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619349362 PECOS PAC ID: 5092183889 Enrollment ID: I20221129002101 |
| Provider Name | Kelsey G Purcell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083113807 PECOS PAC ID: 3274902747 Enrollment ID: I20221206002275 |
| Provider Name | Andrea L Ferrante |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720688989 PECOS PAC ID: 4587033386 Enrollment ID: I20221219001306 |
| Provider Name | Lemarr J Leggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306199112 PECOS PAC ID: 0244696961 Enrollment ID: I20230522002291 |
| Provider Name | Amelia A Steves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760074462 PECOS PAC ID: 9830547884 Enrollment ID: I20231130003161 |
| Provider Name | Gisell M Perez Ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437606308 PECOS PAC ID: 2365887981 Enrollment ID: I20240305001223 |
| Provider Name | Amber R Johnson-raj |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891310769 PECOS PAC ID: 6204272420 Enrollment ID: I20240311002351 |
Puerto Rican Family Institute, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9131 Queens Blvd Ste 618, Elmhurst, NY 11373 Phone: 718-275-0983 Fax: 718-275-7973 | |
M Q Islam Physician, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 40-27 74th Street, Elmhurst, NY 11373 Phone: 718-424-1300 Fax: 718-424-1311 | |
Brain Injury Medicine Associates Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9131 Queens Blvd, Elmhurst, NY 11373 Phone: 718-454-2222 Fax: 718-264-0257 | |
Elmhurst Hospital Center Supportive Case Management Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7901 Broadway, Suite D8, Elmhurst, NY 11373 Phone: 718-334-4900 Fax: 718-334-1026 | |
New York Neurology Services Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9405 60th Ave, Elmhurst, NY 11373 Phone: 718-393-3965 | |
Nyc Medical & Neurological Offices, P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 9131 Queens Blvd, Elmhurst, NY 11373 Phone: 718-454-2222 Fax: 718-264-0257 |