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General NPI Number Information
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NPI Number | 1578712501
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Entity Type | Individual
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Provider Name | ZOE AMBRE LANDERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 31 WASHINGTON SQUARE PARK WEST SUITE 5R
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 646-206-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 333 E 92ND ST APT #5A
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City | NEW YORK
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State | NY
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Zip | 10128-5466
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Country | US
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Telephone | 646-206-6449
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 057775
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 73-078671
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License Number State | NY
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