Provider Demographics
NPI:1174658223
Name:RABINOWITZ, OTILIA TERRIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:OTILIA
Middle Name:TERRIE
Last Name:RABINOWITZ
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 1:20 BROADHOLLOW RD STE 3010
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2510
Mailing Address - Country:US
Mailing Address - Phone:516-826-0081
Mailing Address - Fax:
Practice Address - Street 1:20 BROADHOLLOW RD STE 3010
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2510
Practice Address - Country:US
Practice Address - Phone:516-826-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033533-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health