Provider Demographics
NPI:1407189384
Name:PRAGER, LUCY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:
Last Name:PRAGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LUCY
Other - Middle Name:PRAGER
Other - Last Name:WEINTRAUB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:136 E 76TH ST
Mailing Address - Street 2:APT 16AB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2825
Mailing Address - Country:US
Mailing Address - Phone:646-662-2148
Mailing Address - Fax:
Practice Address - Street 1:211 E 43RD ST
Practice Address - Street 2:SUITE 1305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4707
Practice Address - Country:US
Practice Address - Phone:646-662-2148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0776851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03887276Medicaid