Provider Demographics
NPI:1215277355
Name:EHRLICH, NANCY FAYE (LCSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:FAYE
Last Name:EHRLICH
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 1:212 RINGGOLD ST
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3309
Mailing Address - Country:US
Mailing Address - Phone:914-737-4542
Mailing Address - Fax:914-739-4664
Practice Address - Street 1:212 RINGGOLD ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3309
Practice Address - Country:US
Practice Address - Phone:914-737-4542
Practice Address - Fax:914-739-4664
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0178521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001012341Medicaid