Healthcare Provider Details

I. General information

NPI: 1265598825
Provider Name (Legal Business Name): DONNA LYNN ELKIN LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 FULLERTON AVE
NEWBURGH NY
12550-3744
US

IV. Provider business mailing address

14 STONEHEDGE AVE
NEW PALTZ NY
12561-3126
US

V. Phone/Fax

Practice location:
  • Phone: 845-255-4343
  • Fax: 877-224-9708
Mailing address:
  • Phone: 845-255-4343
  • Fax: 877-224-9708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberR0344411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: