Provider Demographics
NPI:1033412101
Name:KALTER, BRACHA Y (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:BRACHA
Middle Name:Y
Last Name:KALTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14733 76TH AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3104
Mailing Address - Country:US
Mailing Address - Phone:718-725-8750
Mailing Address - Fax:
Practice Address - Street 1:9745 QUEENS BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2116
Practice Address - Country:US
Practice Address - Phone:718-830-9274
Practice Address - Fax:718-966-4562
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081692-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker