Provider Demographics
NPI:1821334723
Name:BRESNICK, MARJORIE B (LCSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:B
Last Name:BRESNICK
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 1:10 PLAZA ST E STE 1C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4939
Mailing Address - Country:US
Mailing Address - Phone:718-832-1138
Mailing Address - Fax:
Practice Address - Street 1:10 PLAZA ST E STE 1C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4939
Practice Address - Country:US
Practice Address - Phone:718-832-1138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-046527-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical