Provider Demographics
NPI:1699815191
Name:HALPERN, ELYSA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELYSA
Middle Name:
Last Name:HALPERN
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 1:340 E 73RD ST
Mailing Address - Street 2:APT. 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4454
Mailing Address - Country:US
Mailing Address - Phone:212-517-8935
Mailing Address - Fax:
Practice Address - Street 1:340 E 73RD ST
Practice Address - Street 2:SUITE 4C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4454
Practice Address - Country:US
Practice Address - Phone:212-517-8935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045571104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker