Provider Demographics
NPI:1588893069
Name:LILAKOS, MONIQUE ALICIA (LCSW)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ALICIA
Last Name:LILAKOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:ALICIA
Other - Last Name:ISRAEL-LILAKOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 ALEXANDER ST
Mailing Address - Street 2:222
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-7556
Mailing Address - Country:US
Mailing Address - Phone:914-424-8657
Mailing Address - Fax:
Practice Address - Street 1:1 ALEXANDER ST
Practice Address - Street 2:222
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-7556
Practice Address - Country:US
Practice Address - Phone:914-424-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075384171W00000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171W00000XOther Service ProvidersContractor