Provider Demographics
NPI:1699388074
Name:FIORE, REBECCA D (LMSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:FIORE
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 1:57 HALSEY ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1925
Mailing Address - Country:US
Mailing Address - Phone:201-755-0583
Mailing Address - Fax:
Practice Address - Street 1:301 W 140TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1406
Practice Address - Country:US
Practice Address - Phone:212-342-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker