Provider Demographics
NPI:1447248976
Name:FIRST, EVE C (LCSW-R, BCD)
Entity type:Individual
Prefix:MS
First Name:EVE
Middle Name:C
Last Name:FIRST
Suffix:
Gender:F
Credentials:LCSW-R, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HALSTEAD AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2743
Mailing Address - Country:US
Mailing Address - Phone:914-777-7020
Mailing Address - Fax:914-833-1172
Practice Address - Street 1:650 HALSTEAD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2743
Practice Address - Country:US
Practice Address - Phone:914-777-7020
Practice Address - Fax:914-833-1172
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033056-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02239476Medicaid
NYN71472Medicare ID - Type Unspecified