Provider Demographics
NPI:1003968694
Name:MAHLER, ELSBETH H (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELSBETH
Middle Name:H
Last Name:MAHLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELSBETH
Other - Middle Name:MARGARET
Other - Last Name:HULBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:337 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2344
Mailing Address - Country:US
Mailing Address - Phone:516-431-9701
Mailing Address - Fax:
Practice Address - Street 1:337 E STATE ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2344
Practice Address - Country:US
Practice Address - Phone:516-431-9701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR00674311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY109423OtherVALUE OPTIONS
N10443Medicare UPIN