Provider Demographics
NPI:1013242585
Name:PLOTKIN SAFYER, MARCY D (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:D
Last Name:PLOTKIN SAFYER
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 N LINCOLN AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-9192
Mailing Address - Country:US
Mailing Address - Phone:716-830-4522
Mailing Address - Fax:
Practice Address - Street 1:2671 N LINCOLN AVE APT 3E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-9192
Practice Address - Country:US
Practice Address - Phone:716-830-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063141-11041C0700X
IL149.0226161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR57728771OtherBLUE CROSS/BLUE SHIELD FEDERAL PLAN