Provider Demographics
NPI:1336358613
Name:ENGELKEN, CORT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CORT
Middle Name:
Last Name:ENGELKEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 KNIGHTSBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3851
Mailing Address - Country:US
Mailing Address - Phone:914-582-7093
Mailing Address - Fax:845-356-2065
Practice Address - Street 1:20 KNIGHTSBRIDGE CT
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3851
Practice Address - Country:US
Practice Address - Phone:914-582-7093
Practice Address - Fax:845-356-2065
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031635-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical