MEDICARE: MS. ELISABETH ANNE HUNSICKER L.C.S.W.

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
1	1041C0700X	Clinical Social Worker	076002	NY

General Provider Information

NPI Number	:	1194831735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELISABETH ANNE HUNSICKER L.C.S.W.

Provider Business Mailing Address
First Line	:	104 PIERREPONT ST APT 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-2761
Country	:	US
Telephone Number	:	917-439-0843
Fax Number	:	347-328-8117

Provider Business Practice Location Address
First Line	:	180 LIVINGSTON ST STE 303
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5861
Country	:	US
Telephone Number	:	718-928-6949
Fax Number	:	347-328-8117

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	11/18/2007

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