Provider Demographics
NPI:1114151495
Name:LOSADA, ERIC (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:LOSADA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 W 172ND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1723
Mailing Address - Country:US
Mailing Address - Phone:646-631-9103
Mailing Address - Fax:347-694-4958
Practice Address - Street 1:347 5TH AVE RM 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5050
Practice Address - Country:US
Practice Address - Phone:646-631-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0896181041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical