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General NPI Number Information
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NPI Number | 1013605971
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Entity Type | Organization
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Legal Business Name | ELYSE D. SCHUNKEWITZ, LCSW, PLLC
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 220 5TH AVE FL 11
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City | NEW YORK
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State | NY
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Zip | 10001-8017
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Country | US
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Telephone | 929-352-0215
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Fax |
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Provider Business Mailing Address
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Address Line | 3157 31ST ST APT 422
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City | ASTORIA
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State | NY
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Zip | 11106-2783
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Country | US
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Telephone | 973-769-9882
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ELYSE SCHUNKEWITZ
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Credential | LCSW
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Telephone | 973-769-9882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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