Provider Demographics
NPI:1275682593
Name:SCHULMAN, DAVID MARK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARK
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DAVID
Other - Middle Name:MARK
Other - Last Name:SCHULMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:130 PONDFIELD RD
Mailing Address - Street 2:SUITE#2
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4002
Mailing Address - Country:US
Mailing Address - Phone:914-337-3253
Mailing Address - Fax:914-771-5278
Practice Address - Street 1:130 PONDFIELD RD
Practice Address - Street 2:SUITE#2
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4002
Practice Address - Country:US
Practice Address - Phone:914-337-3253
Practice Address - Fax:914-771-5278
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054935-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY557813OtherVALUE OPTIONS