Provider Demographics
NPI:1851494454
Name:BELKIN, ELIZABETH MARY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARY
Last Name:BELKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WEST 86TH STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-496-0324
Mailing Address - Fax:212-877-3691
Practice Address - Street 1:21 WEST 86TH STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-496-0324
Practice Address - Fax:212-877-3691
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0407151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3625754OtherOXFORD
NYN6K961Medicare ID - Type Unspecified