Provider Demographics
NPI:1255591087
Name:VELSINI, ERIN LORRAINE (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LORRAINE
Last Name:VELSINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LORRAINE
Other - Last Name:BIGELOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:7513 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932
Mailing Address - Country:US
Mailing Address - Phone:518-873-3670
Mailing Address - Fax:518-873-3777
Practice Address - Street 1:7513 COURT STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932
Practice Address - Country:US
Practice Address - Phone:518-873-3670
Practice Address - Fax:518-873-3777
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080968-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02996789Medicaid
NY02996789Medicaid