National Provider Identifier

Elisse Marie Antczak, LCSWR

Elisse Marie Antczak, LCSWR is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Snyder, NY and a listed phone number of (716) 238-0829.

NPI 1316008352Snyder, NYClinical Social Worker

Profile Overview

NPI
1316008352
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
December 13, 2006
Last Updated
September 07, 2022

Practice Location

  • 3960 Harlem RD Ste 10
  • Snyder, NY 14226-4706

Phone: (716) 238-0829

Mailing Address

  • 3960 Sheridan Drive
  • Suite 10
  • Snyder, NY 14226

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1316008352
Entity Type
Individual
Last Name
Antczak
First Name
Elisse
Middle Name
Marie
Credential
LCSWR
Mailing Street Address
3960 Sheridan Drive
Mailing Address Line 2
Suite 10
Mailing City
Snyder
Mailing State
NY
Mailing ZIP Code
14226
Mailing Country
US
Mailing Phone
(716) 238-0829
Mailing Fax
(716) 898-8802
Practice Street Address
3960 Harlem RD Ste 10
Practice City
Snyder
Practice State
NY
Practice ZIP Code
14226-4706
Practice Country
US
Practice Phone
(716) 238-0829
Practice Fax
(716) 898-8802
Enumeration Date
December 13, 2006
Last Updated
September 07, 2022
Sex
Female
Sole Proprietor
Yes
Certification Date
September 07, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)
Other Identifiers
6211545 (NY, Independent Health), 00026849603 (NY, Univera), 000526673002 (NY, Blue Cross & Blue Shield)