Provider Demographics
NPI:1821299579
Name:OSTROV, VIVIAN JOY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:JOY
Last Name:OSTROV
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MR
Other - First Name:STEWART
Other - Middle Name:LEON
Other - Last Name:OSTROV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:651 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5220
Mailing Address - Country:US
Mailing Address - Phone:718-337-0824
Mailing Address - Fax:718-327-2272
Practice Address - Street 1:651 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5220
Practice Address - Country:US
Practice Address - Phone:718-337-0824
Practice Address - Fax:718-327-2272
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR010043-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical