Provider Demographics
NPI:1942347547
Name:SPADACCINI, ELIZABETH JOAN (MS, LMSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOAN
Last Name:SPADACCINI
Suffix:
Gender:F
Credentials:MS, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 WEST 239TH APT 6K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1258
Mailing Address - Country:US
Mailing Address - Phone:718-796-2699
Mailing Address - Fax:
Practice Address - Street 1:1225 GERARD AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452
Practice Address - Country:US
Practice Address - Phone:718-960-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073168104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker