Provider Demographics
NPI:1598834756
Name:RICE, SHELDON M (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:M
Last Name:RICE
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 1:474 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2503
Mailing Address - Country:US
Mailing Address - Phone:718-768-8768
Mailing Address - Fax:
Practice Address - Street 1:474 2ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2503
Practice Address - Country:US
Practice Address - Phone:718-768-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0129731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00012973Medicaid
NY6274959OtherUNITED HEALTH CARE
NYPR012973-A37OtherHEALTHFIRST
NYW22701OtherMAGELLAN
NY00012973Medicaid