Provider Demographics
NPI:1710076062
Name:STOLKINER, MAYA (LCSW)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:STOLKINER
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 1:244 JEFFERSON ST APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-2122
Mailing Address - Country:US
Mailing Address - Phone:917-365-0566
Mailing Address - Fax:
Practice Address - Street 1:244 JEFFERSON ST APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-2122
Practice Address - Country:US
Practice Address - Phone:917-365-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0764441041C0700X
NY070642104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3641366OtherOXFORD