Provider Demographics
NPI:1790173532
Name:HOROWITZ, TED JOEL (LCSW)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:JOEL
Last Name:HOROWITZ
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 1:2280 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9206
Mailing Address - Country:US
Mailing Address - Phone:516-526-1014
Mailing Address - Fax:518-456-6512
Practice Address - Street 1:2280 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-9206
Practice Address - Country:US
Practice Address - Phone:516-526-1014
Practice Address - Fax:518-456-6512
Is Sole Proprietor?:No
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR019413-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical