Healthcare Provider Details

I. General information

NPI: 1992975676
Provider Name (Legal Business Name): ELIZABETH ANN SELLATI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 LAFAYETTE ST
SCHENECTADY NY
12305-2408
US

IV. Provider business mailing address

600 MCCLELLAN ST 2 WEST
SCHENECTADY NY
12304-1009
US

V. Phone/Fax

Practice location:
  • Phone: 518-243-3300
  • Fax: 518-377-9151
Mailing address:
  • Phone: 518-347-5400
  • Fax: 518-347-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number078026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: