Provider Demographics
NPI:1124326525
Name:MASSER, ILENE M (LCSW)
Entity type:Individual
Prefix:MS
First Name:ILENE
Middle Name:M
Last Name:MASSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 PARK AVENUE SOUTH, 5TH FLOOR
Mailing Address - Street 2:CORPORATE COUNSELING ASSOCIATES,
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:917-843-4528
Mailing Address - Fax:
Practice Address - Street 1:475 PARK AVENUE SOUTH
Practice Address - Street 2:CORPORATE COUNSELING ASSOCIATES, 5 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:917-843-4528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR018886-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical