Provider Demographics
NPI:1891920617
Name:STEIN, REBECCA (MSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 PRESIDENT ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1260
Mailing Address - Country:US
Mailing Address - Phone:917-449-0289
Mailing Address - Fax:
Practice Address - Street 1:348 13TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5004
Practice Address - Country:US
Practice Address - Phone:718-788-2461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY0800781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker