Provider Demographics
NPI:1174676159
Name:BUTENSKY, JUDITH ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELLEN
Last Name:BUTENSKY
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 1:109 E 36TH ST
Mailing Address - Street 2:5R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3447
Mailing Address - Country:US
Mailing Address - Phone:212-260-4984
Mailing Address - Fax:
Practice Address - Street 1:109 E 36TH ST
Practice Address - Street 2:5R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3447
Practice Address - Country:US
Practice Address - Phone:212-260-4984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO345561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical