Provider Demographics
NPI:1558687376
Name:AIN, EILEEN JOAN (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:JOAN
Last Name:AIN
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 EAST 10TH STREET
Mailing Address - Street 2:12G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6214
Mailing Address - Country:US
Mailing Address - Phone:212-777-2764
Mailing Address - Fax:
Practice Address - Street 1:80 FIFTH AVENUE,
Practice Address - Street 2:SUITE 1001
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8001
Practice Address - Country:US
Practice Address - Phone:917-747-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069718-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical