Provider Demographics
NPI:1982144994
Name:TEITEL, AIMEE KAITLIN ZYLICH (LCSW)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:KAITLIN ZYLICH
Last Name:TEITEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:ZYLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 5TH AVE FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-8017
Mailing Address - Country:US
Mailing Address - Phone:646-389-7443
Mailing Address - Fax:646-349-6144
Practice Address - Street 1:220 5TH AVE FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-8017
Practice Address - Country:US
Practice Address - Phone:646-389-7443
Practice Address - Fax:646-349-6144
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089333104100000X
NY094017-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker