Provider Demographics
NPI:1073772703
Name:SPRINGER, PHYLLIS D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:D
Last Name:SPRINGER
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 1:544 E 86TH ST
Mailing Address - Street 2:#1SW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7523
Mailing Address - Country:US
Mailing Address - Phone:212-772-8505
Mailing Address - Fax:
Practice Address - Street 1:544 E 86TH ST
Practice Address - Street 2:#1SW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7523
Practice Address - Country:US
Practice Address - Phone:212-772-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015948-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical