Provider Demographics
NPI:1366001463
Name:EISENBERG, HELAINE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:HELAINE
Middle Name:
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E 90TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7913
Mailing Address - Country:US
Mailing Address - Phone:213-831-7671
Mailing Address - Fax:
Practice Address - Street 1:285 W END AVE STE 3YR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2504
Practice Address - Country:US
Practice Address - Phone:212-831-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02297-91041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R029927-1OtherSOCIAL WORKER LIVENCE
NYR029927-1OtherSOCIAL WORK LICENCE
NONEOtherNONE