Provider Demographics
NPI:1295093185
Name:ARMSTRONG, ELIZABETH T (LCSW-R)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 68TH ST
Mailing Address - Street 2:16L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6047
Mailing Address - Country:US
Mailing Address - Phone:917-589-5772
Mailing Address - Fax:
Practice Address - Street 1:111 E 80TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0334
Practice Address - Country:US
Practice Address - Phone:917-589-5772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0759341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY45-5112616OtherEIN