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NPI 1841649274

NPI 1841649274 : ELIZABETH HEALEY LCSW : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1841649274
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH HEALEY LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/07/2016
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    Last Update Date     |    05/19/2020
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Provider Practice Location Address
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    Address Line         |    124 E 40TH ST RM 901 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10016-1766
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    Country              |    US
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    Telephone            |    347-678-0752
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12 ROSE LN 
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    City                 |    CHAPPAQUA
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    State                |    NY
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    Zip                  |    10514-2004
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    Country              |    US
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    Telephone            |    347-678-0752
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    085770
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    License Number State |    NY
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