Provider Demographics
NPI:1417426818
Name:GREFRATH, ELIZABETH HANNAH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HANNAH
Last Name:GREFRATH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:HANNAH
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:703 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1845
Mailing Address - Country:US
Mailing Address - Phone:585-402-3904
Mailing Address - Fax:
Practice Address - Street 1:703 E MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1845
Practice Address - Country:US
Practice Address - Phone:585-402-3904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0939661104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker