Provider Demographics
NPI:1073806980
Name:NOVOK, MAYA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:MAYA
Middle Name:
Last Name:NOVOK
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 1:6 ROMEO LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3818
Mailing Address - Country:US
Mailing Address - Phone:631-786-2142
Mailing Address - Fax:
Practice Address - Street 1:6 ROMEO LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3818
Practice Address - Country:US
Practice Address - Phone:631-786-2142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0823511041C0700X
NY0818251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical