Provider Demographics
NPI:1902537368
Name:LIEF, ILENE (LCSW)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:
Last Name:LIEF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10276-0491
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:93 4TH AVE
Practice Address - Street 2:#491
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6707
Practice Address - Country:US
Practice Address - Phone:646-725-3518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0926391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical