Provider Demographics
NPI:1831306935
Name:HALSTED, ELIZABETH TYLER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:TYLER
Last Name:HALSTED
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:37 WASHINGTON SQUARE PARK WEST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1001
Mailing Address - Country:US
Mailing Address - Phone:212-777-0333
Mailing Address - Fax:212-777-0333
Practice Address - Street 1:37 WASHINGTON SQ W
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9181
Practice Address - Country:US
Practice Address - Phone:212-777-0333
Practice Address - Fax:212-777-0333
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical