Provider Demographics
NPI:1669504775
Name:CRESSEY, SALLY MACFARLIN (LCSW)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:MACFARLIN
Last Name:CRESSEY
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 1:501 FIFTH AVENUE
Mailing Address - Street 2:SUITE 1412
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-682-7650
Mailing Address - Fax:
Practice Address - Street 1:501 FIFTH AVENUE
Practice Address - Street 2:SUITE 1412
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-682-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0693091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2299256OtherCIGNA
P3289751OtherOXFORD