Provider Demographics
NPI:1649301896
Name:RONIS, ELIZABETH (LCSW, BCD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RONIS
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 W 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2536
Mailing Address - Country:US
Mailing Address - Phone:212-877-0868
Mailing Address - Fax:212-877-0868
Practice Address - Street 1:35 W 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2536
Practice Address - Country:US
Practice Address - Phone:212-877-0868
Practice Address - Fax:212-877-0868
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR 185021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical