Provider Demographics
NPI:1689832685
Name:GOLUB, RITA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:M
Last Name:GOLUB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RIVERSIDE DRIVE
Mailing Address - Street 2:#2E
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-580-0337
Mailing Address - Fax:
Practice Address - Street 1:60 RIVERSIDE DRIVE
Practice Address - Street 2:#2E
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-580-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01797411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical