Provider Demographics
NPI:1689230922
Name:RASMUSSEN, DAVID STEINAR (LMSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEINAR
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-4908
Mailing Address - Country:US
Mailing Address - Phone:518-565-4060
Mailing Address - Fax:518-566-0168
Practice Address - Street 1:130 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12903-4908
Practice Address - Country:US
Practice Address - Phone:518-565-4060
Practice Address - Fax:518-566-0168
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079060-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical