Provider Demographics
NPI:1831873892
Name:PHILLIPS, BETH (MSW)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 72ND ST APT C3205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4779
Mailing Address - Country:US
Mailing Address - Phone:917-929-8499
Mailing Address - Fax:
Practice Address - Street 1:360 E 72ND ST APT C3205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4779
Practice Address - Country:US
Practice Address - Phone:917-929-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker