Provider Demographics
NPI:1033276423
Name:AMIN, RUCHI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RUCHI
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 LEFFERTS AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4344
Mailing Address - Country:US
Mailing Address - Phone:917-636-9027
Mailing Address - Fax:
Practice Address - Street 1:26 W 9TH ST
Practice Address - Street 2:SUITE 8C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8971
Practice Address - Country:US
Practice Address - Phone:917-635-9027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077221-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331954Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331943Medicare Oscar/Certification