Provider Demographics
NPI:1023061819
Name:GRECIA, LIZZETTE VANESA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LIZZETTE
Middle Name:VANESA
Last Name:GRECIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LIZZETTE
Other - Middle Name:VANESA
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:800 POLY PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7104
Mailing Address - Country:US
Mailing Address - Phone:718-836-6600
Mailing Address - Fax:718-630-2950
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:718-630-2950
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0695501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical