Provider Demographics
NPI:1235295817
Name:WESTERN, ELFIDIA MILAGROS (MA)
Entity Type:Individual
Prefix:
First Name:ELFIDIA
Middle Name:MILAGROS
Last Name:WESTERN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FORDHAM HILL OVAL APT 15C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4843
Mailing Address - Country:US
Mailing Address - Phone:718-584-9193
Mailing Address - Fax:
Practice Address - Street 1:2250 RYER AVE
Practice Address - Street 2:FORDHAM-TREMONT CMHC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1104
Practice Address - Country:US
Practice Address - Phone:718-960-0652
Practice Address - Fax:718-563-4478
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health