Provider Demographics
NPI:1295447399
Name:GELFAND, MICHAEL HOWARD
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HOWARD
Last Name:GELFAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:HOWARD
Other - Last Name:GELFAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:83 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:PURLING
Mailing Address - State:NY
Mailing Address - Zip Code:12470-2724
Mailing Address - Country:US
Mailing Address - Phone:518-622-9660
Mailing Address - Fax:
Practice Address - Street 1:713 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3001
Practice Address - Country:US
Practice Address - Phone:518-828-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker