Provider Demographics
NPI:1316626716
Name:LEWITZKI, ELLA (CASAC)
Entity type:Individual
Prefix:MS
First Name:ELLA
Middle Name:
Last Name:LEWITZKI
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BRIGHTWATER CT APT 506
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7170
Mailing Address - Country:US
Mailing Address - Phone:646-399-6001
Mailing Address - Fax:
Practice Address - Street 1:501 BRIGHTWATER CT APT 506
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7170
Practice Address - Country:US
Practice Address - Phone:646-399-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37101101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)