Provider Demographics
NPI:1841312857
Name:FOGLINO, ELIZABETH O'CONNOR (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O'CONNOR
Last Name:FOGLINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:WRIGHT
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:24 E 12TH ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4403
Mailing Address - Country:US
Mailing Address - Phone:212-675-9122
Mailing Address - Fax:
Practice Address - Street 1:24 E 12TH ST
Practice Address - Street 2:SUITE 505
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4403
Practice Address - Country:US
Practice Address - Phone:212-675-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-056881-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2531982OtherOXFORD PROVIDER NUMBER