Provider Demographics
NPI:1528565462
Name:RASHBAUM, VICTORIA NAN (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NAN
Last Name:RASHBAUM
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 1:37 HARRISON DR
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2529
Mailing Address - Country:US
Mailing Address - Phone:914-715-9098
Mailing Address - Fax:
Practice Address - Street 1:999 WILMOT RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6834
Practice Address - Country:US
Practice Address - Phone:914-472-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-08
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0146071041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool