Provider Demographics
NPI:1043421191
Name:ATKINSON, PHOEBE A (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:PHOEBE
Middle Name:A
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W 82ND ST
Mailing Address - Street 2:APT #2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5336
Mailing Address - Country:US
Mailing Address - Phone:212-724-4424
Mailing Address - Fax:
Practice Address - Street 1:1 PATCHIN PL
Practice Address - Street 2:#3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8341
Practice Address - Country:US
Practice Address - Phone:212-947-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR05987-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical