Provider Demographics
NPI:1295841724
Name:ATKINS, JUDITH ELKAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ELKAN
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 EDGEWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2205
Mailing Address - Country:US
Mailing Address - Phone:914-584-7766
Mailing Address - Fax:
Practice Address - Street 1:89 EDGEWOOD AVE.
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2205
Practice Address - Country:US
Practice Address - Phone:914-584-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0719931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN39Y21Medicare PIN