Provider Demographics
NPI:1558589358
Name:GOLDSTEIN, ROCHELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHELLE
Other - Middle Name:
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:102 TENNYSON DR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1040
Mailing Address - Country:US
Mailing Address - Phone:845-623-6354
Mailing Address - Fax:
Practice Address - Street 1:101 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1929
Practice Address - Country:US
Practice Address - Phone:845-627-7605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0340281102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst