Provider Demographics
NPI:1053066571
Name:MARKS, ELIZABETH CLAIRE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:MARKS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:C
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:200 E 64TH ST APT 21D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7426
Mailing Address - Country:US
Mailing Address - Phone:914-772-2037
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1606
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6649
Practice Address - Country:US
Practice Address - Phone:917-510-4317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1129011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112901OtherLICENSED MASTER SOCIAL WORK