Provider Demographics
NPI:1205854031
Name:SALAMON, ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SALAMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:SALAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 COURT ST
Mailing Address - Street 2:APT 9N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5663
Mailing Address - Country:US
Mailing Address - Phone:347-682-8878
Mailing Address - Fax:
Practice Address - Street 1:125 COURT ST
Practice Address - Street 2:APT 9N
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5663
Practice Address - Country:US
Practice Address - Phone:347-682-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P61361Medicare UPIN
N4Y061Medicare ID - Type Unspecified