Provider Demographics
NPI:1588045447
Name:HABER, RENEE (LMSW)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HABER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CRABAPPLE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2300
Mailing Address - Country:US
Mailing Address - Phone:516-621-0044
Mailing Address - Fax:516-801-3139
Practice Address - Street 1:2116 MERRICK AVE
Practice Address - Street 2:3008
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3445
Practice Address - Country:US
Practice Address - Phone:516-578-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094354-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker