Provider Demographics
NPI:1538541297
Name:SANTANA, ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SANTANA
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 1:3640 JOHNSON AVE
Mailing Address - Street 2:APT 3F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1617
Mailing Address - Country:US
Mailing Address - Phone:347-346-3698
Mailing Address - Fax:
Practice Address - Street 1:3640 JOHNSON AVE
Practice Address - Street 2:APT 3F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1617
Practice Address - Country:US
Practice Address - Phone:347-346-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker