Provider Demographics
NPI:1407204936
Name:KUBINAK, STEFANIE (LMSW)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:KUBINAK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 FRISBY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3240
Mailing Address - Country:US
Mailing Address - Phone:718-239-1610
Mailing Address - Fax:718-792-7053
Practice Address - Street 1:2590 FRISBY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3240
Practice Address - Country:US
Practice Address - Phone:718-239-1610
Practice Address - Fax:718-792-7053
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0951381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical