Basic Information
| Provider Information | |||||||||
| NPI: | 1760874614 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | ELENA | ||||||||
| MiddleName: | JULIA | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3250 US ROUTE 9W | ||||||||
| Address2: | |||||||||
| City: | NEW WINDSOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125536756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455629816 | ||||||||
| FaxNumber: | 8458630351 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 LAUREL AVE | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | CORNWALL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125181469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455512323 | ||||||||
| FaxNumber: | 8454584559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2015 | ||||||||
| LastUpdateDate: | 02/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 006351 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.