Provider Demographics
NPI:1689753154
Name:ANTRIM, LUCINDA (LCSW, LP)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:
Last Name:ANTRIM
Suffix:
Gender:F
Credentials:LCSW, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 E 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3701
Mailing Address - Country:US
Mailing Address - Phone:914-473-2981
Mailing Address - Fax:
Practice Address - Street 1:351 E 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3701
Practice Address - Country:US
Practice Address - Phone:914-473-2981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2011-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000811102L00000X
NY078040-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst