Provider Demographics
NPI:1710309190
Name:MOZER, EKATERINA (LMSW, CASAC)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:MOZER
Suffix:
Gender:F
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 BRIGHTON 2ND ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7523
Mailing Address - Country:US
Mailing Address - Phone:646-761-3743
Mailing Address - Fax:
Practice Address - Street 1:3111 BRIGHTON 2ND ST APT 2C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7523
Practice Address - Country:US
Practice Address - Phone:646-761-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090108104100000X
NY0860791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker