Provider Demographics
NPI:1821031378
Name:HORNIK, MARJORIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:
Last Name:HORNIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5350
Mailing Address - Country:US
Mailing Address - Phone:212-222-8990
Mailing Address - Fax:212-280-3535
Practice Address - Street 1:140 W 79TH ST
Practice Address - Street 2:SUITE 1-D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6421
Practice Address - Country:US
Practice Address - Phone:212-222-8990
Practice Address - Fax:212-280-3535
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0318491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR031849OtherSOCIAL WORK LICENSE
NYN7M001Medicare ID - Type UnspecifiedSOCIAL WORKER