Provider Demographics
NPI:1982760468
Name:JEAN-PIERRE, ELSIE (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:
Last Name:JEAN-PIERRE
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:DR
Other - First Name:ELSIE
Other - Middle Name:
Other - Last Name:JEAN-PIERRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, PHD
Mailing Address - Street 1:26 COURT ST
Mailing Address - Street 2:SUITE 2111
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-0103
Mailing Address - Country:US
Mailing Address - Phone:718-522-1500
Mailing Address - Fax:718-522-1535
Practice Address - Street 1:26 COURT STREET
Practice Address - Street 2:SUITE 2111
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242
Practice Address - Country:US
Practice Address - Phone:718-522-1500
Practice Address - Fax:718-522-1535
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018319-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300022768Medicare PIN