Provider Demographics
NPI:1275953127
Name:STERN, TERESA (LMSW, SEP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:LMSW, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 ADELPHI ST
Mailing Address - Street 2:#2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4672
Mailing Address - Country:US
Mailing Address - Phone:917-698-5022
Mailing Address - Fax:
Practice Address - Street 1:281 ADELPHI ST
Practice Address - Street 2:#2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4672
Practice Address - Country:US
Practice Address - Phone:917-698-5022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker