Healthcare Provider Details

I. General information

NPI: 1326117284
Provider Name (Legal Business Name): EILEEN YIP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 MAIN ST WJCS
NEW ROCHELLE NY
10801-6431
US

IV. Provider business mailing address

8 AGNEW FARM RD UNIT 3A
ARMONK NY
10504-1377
US

V. Phone/Fax

Practice location:
  • Phone: 914-632-6433
  • Fax: 914-632-2265
Mailing address:
  • Phone: 914-632-6433
  • Fax: 914-632-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR052970
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: