Provider Demographics
NPI:1366796120
Name:ACOSTA, ELYSIA B (LMSW)
Entity type:Individual
Prefix:
First Name:ELYSIA
Middle Name:B
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:2 PERLMAN DR
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5245
Practice Address - Country:US
Practice Address - Phone:845-573-9860
Practice Address - Fax:845-573-9865
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY055606104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker