Provider Demographics
NPI:1811900046
Name:ARON, ELYSE (LCSW)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:ARON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 JERICHO TPKE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4532
Mailing Address - Country:US
Mailing Address - Phone:631-680-4467
Mailing Address - Fax:631-262-0811
Practice Address - Street 1:175 JERICHO TPKE
Practice Address - Street 2:SUITE 104
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4532
Practice Address - Country:US
Practice Address - Phone:631-680-4467
Practice Address - Fax:631-262-0811
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0833351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical