Provider Demographics
NPI:1407945975
Name:AUCLAIR, URSULA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:URSULA
Middle Name:
Last Name:AUCLAIR
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 9TH AVE
Mailing Address - Street 2:SUITE 16D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5702
Mailing Address - Country:US
Mailing Address - Phone:212-366-5474
Mailing Address - Fax:212-263-3273
Practice Address - Street 1:280 9TH AVE
Practice Address - Street 2:SUITE 16D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5702
Practice Address - Country:US
Practice Address - Phone:212-366-5474
Practice Address - Fax:212-263-3273
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0522431041C0700X
NYR052243-11041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR052243OtherHIP
NYR052243OtherHIP