Healthcare Provider Details

I. General information

NPI: 1043888217
Provider Name (Legal Business Name): ELIZABETH A. H. CIVIK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH HORSBURGH LMSW

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 UNION ST STE 2B
BROOKLYN NY
11215-1375
US

IV. Provider business mailing address

808 UNION ST STE 2B
BROOKLYN NY
11215-1375
US

V. Phone/Fax

Practice location:
  • Phone: 646-886-8776
  • Fax:
Mailing address:
  • Phone: 440-856-3443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100254
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: