Provider Demographics
NPI:1437407004
Name:GUTTMAN, MAX EDWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MAX
Middle Name:EDWARD
Last Name:GUTTMAN
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 1:941 MCLEAN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4107
Mailing Address - Country:US
Mailing Address - Phone:914-400-7566
Mailing Address - Fax:
Practice Address - Street 1:411 BRONX RIVER RD APT 3E
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3429
Practice Address - Country:US
Practice Address - Phone:914-400-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086698-1104100000X
NY0842151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker