Provider Demographics
NPI:1497995468
Name:CITRONENBAUM, ZEVA ADLER (LCSWR)
Entity Type:Individual
Prefix:
First Name:ZEVA
Middle Name:ADLER
Last Name:CITRONENBAUM
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 ROUTE 202 # 105
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2901
Mailing Address - Country:US
Mailing Address - Phone:914-646-3164
Mailing Address - Fax:
Practice Address - Street 1:11 JAY CT
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1627
Practice Address - Country:US
Practice Address - Phone:914-646-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YA0400X
NYR069590-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)