Provider Demographics
NPI:1558609636
Name:MUSHKIN, REBECCA LEE (LCSW)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LEE
Last Name:MUSHKIN
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 1:46 LAKE MARIE LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1229
Mailing Address - Country:US
Mailing Address - Phone:914-864-1980
Mailing Address - Fax:
Practice Address - Street 1:6355 BROADWAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2701
Practice Address - Country:US
Practice Address - Phone:718-796-4424
Practice Address - Fax:718-884-8096
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical