Provider Demographics
NPI:1831270503
Name:QUIGLEY, ELAINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:QUIGLEY
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 1:240 BAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758
Mailing Address - Country:US
Mailing Address - Phone:516-797-0601
Mailing Address - Fax:516-799-6137
Practice Address - Street 1:4585 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MASSAPEGUA
Practice Address - State:NY
Practice Address - Zip Code:11758
Practice Address - Country:US
Practice Address - Phone:516-797-0601
Practice Address - Fax:516-799-6137
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018833-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical