Provider Demographics
NPI:1033715057
Name:LEIMSIDER, ELISA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:LEIMSIDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 35TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4213
Mailing Address - Country:US
Mailing Address - Phone:917-748-0978
Mailing Address - Fax:
Practice Address - Street 1:240 E 35TH ST APT 4E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4213
Practice Address - Country:US
Practice Address - Phone:917-748-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076731-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical