Provider Demographics
NPI:1023366580
Name:REID, ELAINE E (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:E
Last Name:REID
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:E
Other - Last Name:SILBURN-REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:772 VERMONT STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207
Mailing Address - Country:US
Mailing Address - Phone:347-432-9368
Mailing Address - Fax:718-272-0406
Practice Address - Street 1:772 VERMONT STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207
Practice Address - Country:US
Practice Address - Phone:347-432-9368
Practice Address - Fax:718-272-0406
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048594104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker