Provider Demographics
NPI:1568784387
Name:NOTH, MICHAEL P (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:P
Last Name:NOTH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 41ST ST
Mailing Address - Street 2:#1007
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5955
Mailing Address - Country:US
Mailing Address - Phone:917-226-5764
Mailing Address - Fax:
Practice Address - Street 1:325 E 41ST ST
Practice Address - Street 2:#1007
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5955
Practice Address - Country:US
Practice Address - Phone:917-226-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0577981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical