Provider Demographics
NPI:1053664011
Name:SANCHEZ, KRISTOBAL (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTOBAL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 27TH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6217
Mailing Address - Country:US
Mailing Address - Phone:212-627-0125
Mailing Address - Fax:646-638-3025
Practice Address - Street 1:115 W 27TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6217
Practice Address - Country:US
Practice Address - Phone:212-627-0125
Practice Address - Fax:646-638-3025
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084854-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical