Provider Demographics
NPI:1295976553
Name:JANIE EISENBERG, LCSW, PLLC
Entity type:Organization
Organization Name:JANIE EISENBERG, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-243-1086
Mailing Address - Street 1:24 CHARLTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4923
Mailing Address - Country:US
Mailing Address - Phone:212-243-1086
Mailing Address - Fax:212-243-6834
Practice Address - Street 1:24 CHARLTON STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4923
Practice Address - Country:US
Practice Address - Phone:212-243-1086
Practice Address - Fax:212-243-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR038355-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02690480Medicaid
NYP2578124OtherOXFORD HEALTH PLAN
NY02690480Medicaid