Provider Demographics
NPI:1992030621
Name:SALLICK, MARGARET ELLEN
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELLEN
Last Name:SALLICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ELLEN
Other - Last Name:SALLICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:256 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2134
Mailing Address - Country:US
Mailing Address - Phone:718-387-1199
Mailing Address - Fax:
Practice Address - Street 1:256 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2134
Practice Address - Country:US
Practice Address - Phone:718-387-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730768621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical