Provider Demographics
NPI:1619940319
Name:GILES-MONROE, ESTELLE ARIETTA (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:ESTELLE
Middle Name:ARIETTA
Last Name:GILES-MONROE
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 1:530 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3400
Mailing Address - Country:US
Mailing Address - Phone:518-370-0535
Mailing Address - Fax:
Practice Address - Street 1:20 CENTURY HILL DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2314
Practice Address - Country:US
Practice Address - Phone:518-785-7283
Practice Address - Fax:518-785-7293
Is Sole Proprietor?:No
Enumeration Date:2006-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR060643-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP08689Medicare UPIN
NYIA06444Medicare ID - Type Unspecified