Provider Demographics
NPI:1861816498
Name:PINCUS, MADELINE (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:
Last Name:PINCUS
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:DR
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:PINCUS-MORELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, PHD
Mailing Address - Street 1:3135 JOHNSON AVE
Mailing Address - Street 2:17C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3518
Mailing Address - Country:US
Mailing Address - Phone:917-767-4858
Mailing Address - Fax:347-341-5049
Practice Address - Street 1:1651 3RD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3679
Practice Address - Country:US
Practice Address - Phone:917-767-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032194-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical