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General NPI Number Information
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NPI Number | 1790219533
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Entity Type | Organization
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Legal Business Name | EK5
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 231 W 96TH ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10025-6311
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Country | US
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Telephone | 917-573-3027
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W 145TH ST APT 3P
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City | NEW YORK
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State | NY
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Zip | 10039-3144
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Country | US
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Telephone | 917-573-3027
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ELIZABETH KAPSTEIN
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Credential | LCSW-R
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Telephone | 917-573-3027
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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 | 21573
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License Number State | NY
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