Provider Demographics
NPI:1033358445
Name:SCHONFELD, ILYSE C (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:ILYSE
Middle Name:C
Last Name:SCHONFELD
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 1:31 MERRICK AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3406
Mailing Address - Country:US
Mailing Address - Phone:516-705-8020
Mailing Address - Fax:516-705-8822
Practice Address - Street 1:31 MERRICK AVE STE 120
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3406
Practice Address - Country:US
Practice Address - Phone:516-705-8020
Practice Address - Fax:516-705-8822
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR071558-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical