Provider Demographics
NPI:1215405980
Name:EKANEM, ESTHER WILLIAMS (LMHC, CASAC, NCC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:WILLIAMS
Last Name:EKANEM
Suffix:
Gender:F
Credentials:LMHC, CASAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 WAVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1350
Mailing Address - Country:US
Mailing Address - Phone:631-213-1179
Mailing Address - Fax:
Practice Address - Street 1:312 EXPRESSWAY DR S
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-2555
Practice Address - Country:US
Practice Address - Phone:631-758-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-10
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34658101YA0400X
NY010042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)