Provider Demographics
NPI:1407103476
Name:ELALOUF, NINA (LCSW)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:ELALOUF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:MERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 BRADLEY CT
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2511
Mailing Address - Country:US
Mailing Address - Phone:516-532-2309
Mailing Address - Fax:
Practice Address - Street 1:1 BRADLEY CT
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2511
Practice Address - Country:US
Practice Address - Phone:516-532-2309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0835671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical