Provider Demographics
NPI:1730301151
Name:MULHERN, REBECCA LYNN (MSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:MULHERN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:ADMINISTRATION BUILDING, 4TH FLOOR, ROOM 408
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-3126
Mailing Address - Fax:212-562-5163
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:ADMINISTRATION BUILDING, 4TH FLOOR, ROOM 408
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3126
Practice Address - Fax:212-562-5163
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074751104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker