Provider Demographics
NPI:1467648790
Name:STERN, REBECCA ANNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANNE
Last Name:STERN
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 1:46 E BROADWAY
Mailing Address - Street 2:SIXTH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6803
Mailing Address - Country:US
Mailing Address - Phone:212-343-3561
Mailing Address - Fax:212-966-4176
Practice Address - Street 1:46 E BROADWAY
Practice Address - Street 2:SIXTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6803
Practice Address - Country:US
Practice Address - Phone:212-343-3561
Practice Address - Fax:212-966-4176
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068664-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical