Provider Demographics
NPI:1639446602
Name:O'CONNELL, ELAINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:SHEEHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:330 E 79TH ST APT 1G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0970
Mailing Address - Country:US
Mailing Address - Phone:917-699-4256
Mailing Address - Fax:
Practice Address - Street 1:330 E 79TH ST APT 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0970
Practice Address - Country:US
Practice Address - Phone:917-699-4256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0820781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical