Provider Demographics
NPI:1740235209
Name:LEBOVITS, RIVKAH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RIVKAH
Middle Name:
Last Name:LEBOVITS
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 1:525 CHESTNUT ST STE 206
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2223
Mailing Address - Country:US
Mailing Address - Phone:917-826-2554
Mailing Address - Fax:
Practice Address - Street 1:525 CHESTNUT ST STE 206
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2223
Practice Address - Country:US
Practice Address - Phone:917-826-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NY068508104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00068508Medicaid