Provider Demographics
NPI:1205359817
Name:ROBINSON, ELYSSE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELYSSE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LISI
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:79 ASPETONG RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1116
Mailing Address - Country:US
Mailing Address - Phone:914-234-9594
Mailing Address - Fax:
Practice Address - Street 1:7 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1503
Practice Address - Country:US
Practice Address - Phone:914-262-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0810871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical