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ELLYA INDRADJAJA LMHC
NPI 1659024867
Counselor - Mental Health in Astoria, NY

Active since January 27, 2022PECOS EnrolledAccepts Medicare Assignment
3089 31ST ST APT 1, ASTORIA, NY 11102(646) 377-9724 Get Directions Write a Review

NPPES record last updated: January 27, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ellya Indradjaja Lmhc NPPES

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

ELLYA INDRADJAJA LMHC (NPI 1659024867) is an individual mental health provider in Astoria, New York, licensed in New York (011692) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1659024867
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameELLYA INDRADJAJACredential: LMHC
Location Address3089 31ST ST APT 1Astoria, NY 11102-1975
Mailing Address3089 31st St Apt 1Astoria, NY 11102-1975 · (646) 377-9724
Phone(646) 377-9724
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateJanuary 27, 2022
NPPES CertifiedJanuary 27, 2022
✔ NPI 1659024867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 011692
3089 31ST ST APT 1, Astoria, NY 11102
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ellya Indradjaja Lmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193246346
PECOS Enrollment IDI20250305000616
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Ellya Indradjaja's NPI number?

The NPI number for Ellya Indradjaja is 1659024867. It was assigned to this individual provider in the NPPES registry on January 27, 2022.

Where is Ellya Indradjaja located?

Ellya Indradjaja practices at 3089 31st St Apt 1, Astoria, NY 11102. The listed phone number is (646) 377-9724.

What is Ellya Indradjaja's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Ellya Indradjaja enrolled in Medicare?

Yes. Ellya Indradjaja is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ellya Indradjaja was last updated on January 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.