Provider Demographics
NPI:1891834438
Name:ASTOR, MICHAEL S (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:ASTOR
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 1:5 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-4315
Mailing Address - Country:US
Mailing Address - Phone:516-702-7598
Mailing Address - Fax:
Practice Address - Street 1:83 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2740
Practice Address - Country:US
Practice Address - Phone:516-702-7598
Practice Address - Fax:845-728-0667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR076178-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical