Provider Demographics
NPI:1104037399
Name:OPPENHEIMER, INGEBORG (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:INGEBORG
Middle Name:
Last Name:OPPENHEIMER
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 1:66 PATTON DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1313
Mailing Address - Country:US
Mailing Address - Phone:914-337-0895
Mailing Address - Fax:
Practice Address - Street 1:66 PATTON DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1313
Practice Address - Country:US
Practice Address - Phone:914-337-0895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0157051041C0700X
CT0038361041C0700X
NJ44SC005319001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical