Provider Demographics
NPI:1407334949
Name:STEIN, MICAELA FORSYTH
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:FORSYTH
Last Name:STEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6834 64TH PL
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5250
Mailing Address - Country:US
Mailing Address - Phone:917-753-7609
Mailing Address - Fax:
Practice Address - Street 1:63 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-3945
Practice Address - Country:US
Practice Address - Phone:917-753-7609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical