Provider Demographics
NPI:1811985682
Name:SCHERDIN, ELAINE GODDIESS (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:GODDIESS
Last Name:SCHERDIN
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 1:10 KAYLEEN DR
Mailing Address - Street 2:WINDSOR COUNSELING GROUP, 10 KAYLEEN DRIVE
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7030
Mailing Address - Country:US
Mailing Address - Phone:845-565-6888
Mailing Address - Fax:
Practice Address - Street 1:10 KAYLEEN DR
Practice Address - Street 2:WINDSOR COUNSELING GROUP
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7030
Practice Address - Country:US
Practice Address - Phone:845-565-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0458611104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00542503Medicaid
W06181Medicare ID - Type Unspecified
NY00542503Medicaid