ELISSA KATE KOZLOV PHD
NPI 1518472398
Psychologist in New York, NY

Active since December 03, 2017Opted out of Medicare · through May 23, 2028
1745 BROADWAY FL 17, NEW YORK, NY 10019(212) 851-8100(212) 537-0102 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 17, 2018, Dec 14, 2017, Dec 3, 2017 (3 updates tracked since 2017).

About Elissa Kate Kozlov Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELISSA KATE KOZLOV PHD (NPI 1518472398) is an individual psychologist in New York, New York, licensed in New York (022411) and active in the NPI registry since December 2017. She has opted out of Medicare through May 23, 2028.

NPPES Registry Identity

NPI1518472398
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameELISSA KATE KOZLOVCredential: PHD
Location Address1745 BROADWAY FL 17New York, NY 10019-4642
Mailing Address310 E 75th St, 2hNew York, NY 10021-3314 · (914) 715-3012
Fax(212) 537-0102
Sole ProprietorYes
Enumeration DateDecember 3, 2017
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
NPI 1518472398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NY · 022411
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1745 BROADWAY FL 17, New York, NY 10019

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Elissa Kate Kozlov Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 23, 2022 through May 23, 2028.

Opt-Out Effective DateMay 23, 2022
Opt-Out In Effect ThroughMay 23, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1745 BROADWAY FL 17
NEW YORK, NY 10019
Psychologist (Clinical)
1745 BROADWAY FL 17
NEW YORK, NY 10019
Social Worker (Clinical)
1745 BROADWAY FL 17
NEW YORK, NY 10019

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elissa Kozlov's NPI number?

The NPI number for Elissa Kozlov is 1518472398. It was assigned to this individual provider in the NPPES registry on December 3, 2017.

Where is Elissa Kozlov located?

Elissa Kozlov practices at 1745 Broadway Fl 17, New York, NY 10019. The listed phone number is (212) 851-8100.

What is Elissa Kozlov's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Elissa Kozlov enrolled in Medicare?

No. Elissa Kozlov has opted out of Medicare through May 23, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Elissa Kozlov was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.