Provider Demographics
NPI:1407154651
Name:TRAUB, JAMES (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:TRAUB
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 W END AVE
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2715
Mailing Address - Country:US
Mailing Address - Phone:212-787-4002
Mailing Address - Fax:
Practice Address - Street 1:562 W END AVE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2715
Practice Address - Country:US
Practice Address - Phone:212-787-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0394361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical