Provider Demographics
NPI:1902524911
Name:ELASHAAL, LAILA (MHC-LP)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:ELASHAAL
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7335 GRAND AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1576
Mailing Address - Country:US
Mailing Address - Phone:347-876-5219
Mailing Address - Fax:
Practice Address - Street 1:81 WORTH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3411
Practice Address - Country:US
Practice Address - Phone:212-566-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP117109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health