Provider Demographics
NPI:1093395980
Name:CORCORAN, ELAINE CRISTINA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:CRISTINA
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4248 65TH PL APT 2
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5055
Mailing Address - Country:US
Mailing Address - Phone:516-660-4890
Mailing Address - Fax:
Practice Address - Street 1:4248 65TH PL APT 2
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5055
Practice Address - Country:US
Practice Address - Phone:516-660-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009880101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health