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NPI Code Detail

MEDICARE: ELIZABETH A. H. CIVIK LCSW

MEDICARE: ELIZABETH A. H. CIVIK LCSW
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerNY
21041C0700XClinical Social Worker100254NY

General Provider Information

NPI Number : 1043888217
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH A. H. CIVIK LCSW
Provider Business Mailing Address
First Line : 808 UNION ST STE 2B
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-1375
Country : US
Telephone Number : 440-856-3443
Fax Number :
Provider Business Practice Location Address
First Line : 808 UNION ST STE 2B
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-1375
Country : US
Telephone Number : 646-886-8776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 05/29/2025

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