Provider Demographics
NPI:1427072974
Name:LESSER, ILYSE MEREDITH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ILYSE
Middle Name:MEREDITH
Last Name:LESSER
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 1:1199 PARK AVE
Mailing Address - Street 2:APT. 7E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1711
Mailing Address - Country:US
Mailing Address - Phone:917-757-7040
Mailing Address - Fax:
Practice Address - Street 1:16 E 65TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7030
Practice Address - Country:US
Practice Address - Phone:917-757-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051451-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical