Provider Demographics
NPI:1801109582
Name:HEATHCOTE, ELIZABETH (LCSW-R)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HEATHCOTE
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 1:27 CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2606
Mailing Address - Country:US
Mailing Address - Phone:518-769-4416
Mailing Address - Fax:518-218-9226
Practice Address - Street 1:27 CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2606
Practice Address - Country:US
Practice Address - Phone:518-769-4416
Practice Address - Fax:518-218-9226
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0814151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical