Provider Demographics
NPI:1932939667
Name:ELANA AXELROD LCSW PLLC
Entity type:Organization
Organization Name:ELANA AXELROD LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AXELROD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-219-6683
Mailing Address - Street 1:120 E BEECH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4120
Mailing Address - Country:US
Mailing Address - Phone:631-219-6683
Mailing Address - Fax:
Practice Address - Street 1:70 GLEN COVE RD
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1726
Practice Address - Country:US
Practice Address - Phone:631-219-6683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty