Provider Demographics
NPI:1528369691
Name:SCHPERO, ELISSA J (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:J
Last Name:SCHPERO
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 1:220 WATER ST
Mailing Address - Street 2:APT 234
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1183
Mailing Address - Country:US
Mailing Address - Phone:917-623-1402
Mailing Address - Fax:
Practice Address - Street 1:220 WATER ST
Practice Address - Street 2:APT 234
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1183
Practice Address - Country:US
Practice Address - Phone:917-623-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0740151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical