Provider Demographics
NPI:1841410933
Name:HARRY, ELEANOR (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:
Last Name:HARRY
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 1:80 LA SALLE ST
Mailing Address - Street 2:APT 18B
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4715
Mailing Address - Country:US
Mailing Address - Phone:212-662-1912
Mailing Address - Fax:212-581-2397
Practice Address - Street 1:250 W 57 ST
Practice Address - Street 2:STE 715
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10107-0714
Practice Address - Country:US
Practice Address - Phone:212-662-1912
Practice Address - Fax:212-581-2397
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0301091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP670061OtherOXFORD
N44561Medicare ID - Type Unspecified