Provider Demographics
NPI:1942322482
Name:KRACKOW, HELEN FLORENCE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:FLORENCE
Last Name:KRACKOW
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 1:201 E 28TH ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8538
Mailing Address - Country:US
Mailing Address - Phone:212-683-1780
Mailing Address - Fax:212-685-7128
Practice Address - Street 1:201 E 28TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8538
Practice Address - Country:US
Practice Address - Phone:212-683-1780
Practice Address - Fax:212-685-7128
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-021150-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN18511Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER