Provider Demographics
NPI:1982853685
Name:FELDMAN, ELAINE JOYCE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:JOYCE
Last Name:FELDMAN
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 1:161 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2156
Mailing Address - Country:US
Mailing Address - Phone:516-625-1720
Mailing Address - Fax:
Practice Address - Street 1:161 E BROADWAY
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-2156
Practice Address - Country:US
Practice Address - Phone:516-625-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032901-11041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist