MEDICARE: ELIZABETH F HALTON LCSW-R

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	00032265	NY

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00400166001	OTHER		MEDICARE SENIOR BLUE
12	P00817783	OTHER		MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	040426031843	OTHER	FIDELIS
3	00400166001	OTHER	EMPIRE BC/BS BLUE CARD
4	00400166001	OTHER	EMPIRE BC/BS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	53088	OTHER	MVP
7	00400166001	OTHER	HEALTHNOW INTEGRATED
8	11586598	OTHER	CAQH
9	26749	OTHER	BLUESHIELD
10	N91681	OTHER	BLUECROSS BLUESHIELD
11	00400166001	OTHER	BLUE SHIELD OF NORTHEASTERN NY

NPI Number	:	1043236813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH F HALTON LCSW-R

Provider Business Mailing Address
First Line	:	3043 STATE ROUTE 4
Second Line	:
City	:	HUDSON FALLS
State	:	NY
Zip	:	12839-9632
Country	:	US
Telephone Number	:	518-747-2284
Fax Number	:	518-747-2253

Provider Business Practice Location Address
First Line	:	3043 STATE ROUTE 4
Second Line	:
City	:	HUDSON FALLS
State	:	NY
Zip	:	12839-9632
Country	:	US
Telephone Number	:	518-747-2284
Fax Number	:	518-747-2253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	05/28/2010

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

3043 STATE ROUTE 4
HUDSON FALLS, NY
12839-9632