Provider Demographics
NPI:1760797070
Name:SILLICK, ELIZABETH JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:SILLICK
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 1:90-27 SUTPHIN BLVD, 5TH FLOOR
Mailing Address - Street 2:TRANSITIONAL SERVICES OF NEW YORK
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435
Mailing Address - Country:US
Mailing Address - Phone:718-526-8400
Mailing Address - Fax:718-297-8658
Practice Address - Street 1:90-27 SUTPHIN BLVD, 5TH FLOOR
Practice Address - Street 2:TRANSITIONAL SERVICES OF NEW YORK
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-526-8400
Practice Address - Fax:718-297-8658
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 080078104100000X
NY081420-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker