Provider Demographics
NPI:1972247070
Name:PAULINO, ELIZABETH RENEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:RENEE
Last Name:PAULINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RENEE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:9 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-2465
Mailing Address - Country:US
Mailing Address - Phone:607-201-9757
Mailing Address - Fax:
Practice Address - Street 1:215 FRONT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2424
Practice Address - Country:US
Practice Address - Phone:518-704-5891
Practice Address - Fax:607-321-0302
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108741104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker