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General NPI Number Information
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NPI Number | 1356051759
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Entity Type | Individual
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Provider Name | ELAINE RENE HERRON LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 30 N MAIN AVE
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City | ALBANY
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State | NY
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Zip | 12203-1410
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Country | US
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Telephone | 518-453-6710
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Fax |
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Provider Business Mailing Address
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Address Line | 259 BOYCE RD
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City | NASSAU
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State | NY
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Zip | 12123-2802
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Country | US
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Telephone | 518-649-6141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 117047-01
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License Number State | NY
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