Provider Demographics
NPI:1245950492
Name:ELPIDA PSYCHOTHERAPY LCSW PLLC
Entity type:Organization
Organization Name:ELPIDA PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE -SOLE MEMBER PLLC
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHALA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-535-2099
Mailing Address - Street 1:265 SUNRISE HWY STE 1-134
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4912
Mailing Address - Country:US
Mailing Address - Phone:646-535-2099
Mailing Address - Fax:
Practice Address - Street 1:265 SUNRISE HWY STE 1-134
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4912
Practice Address - Country:US
Practice Address - Phone:646-535-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health