Provider Demographics
NPI:1316471642
Name:ELIAS, PRIYANKA (LMSW)
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WALTER DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-1042
Mailing Address - Country:US
Mailing Address - Phone:914-473-4678
Mailing Address - Fax:
Practice Address - Street 1:6 GRAMATAN AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3208
Practice Address - Country:US
Practice Address - Phone:914-668-9124
Practice Address - Fax:914-668-0940
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker