Provider Demographics
NPI:1891809612
Name:ESCHELBACH, ELIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIN
Middle Name:
Last Name:ESCHELBACH
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 1:131 MANHASSET WOODS RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2612
Mailing Address - Country:US
Mailing Address - Phone:516-365-3358
Mailing Address - Fax:
Practice Address - Street 1:17810 WEXFORD TER
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3050
Practice Address - Country:US
Practice Address - Phone:718-658-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070222-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical