Provider Demographics
NPI:1992459705
Name:WOOD, ELAINA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:MARIE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48A GAIL DR
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1748
Mailing Address - Country:US
Mailing Address - Phone:845-264-3853
Mailing Address - Fax:
Practice Address - Street 1:48A GAIL DR
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1748
Practice Address - Country:US
Practice Address - Phone:845-264-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker