Provider Demographics
NPI:1467680728
Name:KORENSTEIN, MARIAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:
Last Name:KORENSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HERKIMER AVE
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1508
Mailing Address - Country:US
Mailing Address - Phone:516-931-4743
Mailing Address - Fax:
Practice Address - Street 1:19 HERKIMER AVE
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1508
Practice Address - Country:US
Practice Address - Phone:516-931-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR023481-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical