Provider Demographics
NPI:1164672408
Name:ZAKLIN, ERICA LAUREN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LAUREN
Last Name:ZAKLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY
Mailing Address - Street 2:SUITE 616
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:646-957-6708
Mailing Address - Fax:212-305-6614
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:SUITE 616
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:646-957-6708
Practice Address - Fax:212-305-6614
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72074619104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker