Provider Demographics
NPI:1417902404
Name:SLANE, JUDITH NEWBURN (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:NEWBURN
Last Name:SLANE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 8TH AVE
Mailing Address - Street 2:APARTMENT #1-C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3564
Mailing Address - Country:US
Mailing Address - Phone:646-734-8290
Mailing Address - Fax:212-952-3391
Practice Address - Street 1:420 8TH AVE
Practice Address - Street 2:APARTMENT #1-C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3564
Practice Address - Country:US
Practice Address - Phone:646-734-8290
Practice Address - Fax:212-952-3391
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045231-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical