Provider Demographics
NPI:1033209564
Name:WOIKE-GANGA, ELIZABETH (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:WOIKE-GANGA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6501
Mailing Address - Country:US
Mailing Address - Phone:716-626-9016
Mailing Address - Fax:716-626-4271
Practice Address - Street 1:21 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6501
Practice Address - Country:US
Practice Address - Phone:716-626-9016
Practice Address - Fax:716-626-4271
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071273-1104100000X
NY076148-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY076148-1OtherTHE UNIVERSITY OF THE STATE OF NY EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS