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NPI Code Detail

MEDICARE: ELISSA HAIES LCSW

MEDICARE: ELISSA HAIES 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
11041C0700XClinical Social WorkerR0438511NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396818969
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISSA HAIES LCSW
Provider Business Mailing Address
First Line : 1339 EAST 64TH STREET
Second Line :
City : BROOKLYN
State : NY
Zip : 11234
Country : US
Telephone Number : 718-444-2545
Fax Number :
Provider Business Practice Location Address
First Line : 1623 KINGS HWY
Second Line : 4TH FLOOR SUITE 404
City : BROOKLYN
State : NY
Zip : 11229-1209
Country : US
Telephone Number : 718-375-1200
Fax Number : 718-382-3358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 04/20/2012

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