Provider Demographics
NPI:1518290675
Name:MACEK, NOLA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NOLA
Middle Name:ELIZABETH
Last Name:MACEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WARNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEREDITH
Mailing Address - State:NY
Mailing Address - Zip Code:13757-1023
Mailing Address - Country:US
Mailing Address - Phone:917-208-4861
Mailing Address - Fax:
Practice Address - Street 1:140 WARNER HILL RD
Practice Address - Street 2:
Practice Address - City:EAST MEREDITH
Practice Address - State:NY
Practice Address - Zip Code:13757-1023
Practice Address - Country:US
Practice Address - Phone:917-208-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72069923104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker