Provider Demographics
NPI:1487890562
Name:SPELIOS, ATHENA (LMSW)
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:SPELIOS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ATHENA
Other - Middle Name:
Other - Last Name:SPELIOS-TORRAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:26 COURT ST STE 410
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-1134
Mailing Address - Country:US
Mailing Address - Phone:646-898-6286
Mailing Address - Fax:718-788-0640
Practice Address - Street 1:26 COURT ST STE 410
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1134
Practice Address - Country:US
Practice Address - Phone:646-898-6286
Practice Address - Fax:718-788-0640
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055857104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker