Provider Demographics
NPI:1235482209
Name:BLATT, EVE L (MA, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:L
Last Name:BLATT
Suffix:
Gender:F
Credentials:MA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 W 75TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8608
Mailing Address - Country:US
Mailing Address - Phone:212-920-5276
Mailing Address - Fax:
Practice Address - Street 1:125 W 72ND ST STE 6R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3278
Practice Address - Country:US
Practice Address - Phone:347-762-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730797311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical