Provider Demographics
NPI:1710253224
Name:AARONSON, FAY M (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:FAY
Middle Name:M
Last Name:AARONSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 EAST 36 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4822
Mailing Address - Country:US
Mailing Address - Phone:718-707-1166
Mailing Address - Fax:347-713-5327
Practice Address - Street 1:1355 CTY. RTE. 3
Practice Address - Street 2:
Practice Address - City:MARGARETVILLE
Practice Address - State:NY
Practice Address - Zip Code:12455-2747
Practice Address - Country:US
Practice Address - Phone:917-861-5918
Practice Address - Fax:347-713-5327
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037992-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker