Provider Demographics
NPI:1043593213
Name:MULHARE, ELIZABETH SAGURTON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:SAGURTON
Last Name:MULHARE
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 1:99 MAIN ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3109
Mailing Address - Country:US
Mailing Address - Phone:845-358-0919
Mailing Address - Fax:
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:SUITE 212
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3109
Practice Address - Country:US
Practice Address - Phone:845-358-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0789131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical