Provider Demographics
NPI:1376735183
Name:PEABODY, ELIZABETH T (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:T
Last Name:PEABODY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:T
Other - Last Name:PEABODY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ELIZABETH PEABODY
Mailing Address - Street 1:450 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6448
Mailing Address - Country:US
Mailing Address - Phone:212-758-3884
Mailing Address - Fax:212-888-4765
Practice Address - Street 1:386 PARK AVENUE SOUTH
Practice Address - Street 2:MARIA DROSTE SERVICES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-889-4042
Practice Address - Fax:212-889-3936
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074812-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical