Individual
ELSA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
25418 NORTHERN BLVD STE 3, LITTLE NECK, NY 11362-1451
(646) 389-2283
Mailing address
25418 NORTHERN BLVD STE 3, LITTLE NECK, NY 11362-1451
(646) 389-2283
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
022457
NY
103T00000X
Psychologist
022457
NY
103TA0700X
Adult Development & Aging Psychologist
022457
NY
103TB0200X
Cognitive & Behavioral Psychologist
022457
NY
103TC0700X
Clinical Psychologist
Primary
022457
NY
103TC1900X
Counseling Psychologist
022457
NY
103TC2200X
Clinical Child & Adolescent Psychologist
022457
NY
103TF0000X
Family Psychologist
022457
NY
103TR0400X
Rehabilitation Psychologist
022457
NY
Other
Enumeration date
01/30/2018
Last updated
01/02/2020
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