Provider Demographics
NPI:1295007623
Name:NOELLE ELIA, LCSW PC
Entity type:Organization
Organization Name:NOELLE ELIA, LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-834-2657
Mailing Address - Street 1:17 HALCYON TERRACE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1818
Mailing Address - Country:US
Mailing Address - Phone:914-834-2657
Mailing Address - Fax:
Practice Address - Street 1:4 CHATSWORTH AVENUE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:914-834-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0461661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty