Provider Demographics
NPI:1770663684
Name:RAND, JEFFREY (LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:RAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 E 20TH ST
Mailing Address - Street 2:3G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1519
Mailing Address - Country:US
Mailing Address - Phone:212-679-4960
Mailing Address - Fax:212-679-4966
Practice Address - Street 1:290 MADISON AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6308
Practice Address - Country:US
Practice Address - Phone:212-679-4960
Practice Address - Fax:212-679-4966
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0760741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical