Provider Demographics
NPI:1720390545
Name:SCHLAFRIG, EDITH CYPORA (LCSW-R, CASAC)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:CYPORA
Last Name:SCHLAFRIG
Suffix:
Gender:F
Credentials:LCSW-R, CASAC
Other - Prefix:MS
Other - First Name:EDITH
Other - Middle Name:CYPORA
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8412 35TH AVE
Mailing Address - Street 2:APT 2E
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5459
Mailing Address - Country:US
Mailing Address - Phone:917-623-8780
Mailing Address - Fax:
Practice Address - Street 1:8412 35TH AVE
Practice Address - Street 2:APT 2E
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5459
Practice Address - Country:US
Practice Address - Phone:917-623-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7588101YA0400X
NYRO19922-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)