Provider Demographics
NPI:1548244437
Name:ABRAMS, MARSHA LYNNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:LYNNE
Last Name:ABRAMS
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 1:20 MALVERN LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2835
Mailing Address - Country:US
Mailing Address - Phone:631-941-2896
Mailing Address - Fax:631-941-2896
Practice Address - Street 1:20 MALVERN LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2835
Practice Address - Country:US
Practice Address - Phone:631-941-2896
Practice Address - Fax:631-941-2896
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0573551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP1984593OtherOXFORD INSURANCE
NYP00223390Medicare ID - Type Unspecified