Healthcare Provider Details

I. General information

NPI: 1013242585
Provider Name (Legal Business Name): MARCY D PLOTKIN SAFYER PHD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2671 N LINCOLN AVE APT 3E
CHICAGO IL
60614-9192
US

IV. Provider business mailing address

2671 N LINCOLN AVE APT 3E
CHICAGO IL
60614-9192
US

V. Phone/Fax

Practice location:
  • Phone: 716-830-4522
  • Fax:
Mailing address:
  • Phone: 716-830-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number063141-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.022616
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: