Provider Demographics
NPI:1750446043
Name:EINSTEIN, ELIZABETH ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:EINSTEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:MATTESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:700 WARREN RD APT 12-3B
Mailing Address - Street 2:POST OFFICE BOX 6760
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1204
Mailing Address - Country:US
Mailing Address - Phone:607-272-2552
Mailing Address - Fax:607-272-2552
Practice Address - Street 1:700 WARREN RD APT 12-3B
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1204
Practice Address - Country:US
Practice Address - Phone:607-272-2552
Practice Address - Fax:607-272-2552
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000093106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist