Provider Demographics
NPI:1942388814
Name:WOHLFARTH, RITA LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:LOUISE
Last Name:WOHLFARTH
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 1:175 W 93RD ST
Mailing Address - Street 2:APT.16I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9313
Mailing Address - Country:US
Mailing Address - Phone:212-580-1940
Mailing Address - Fax:
Practice Address - Street 1:175 W 93RD ST
Practice Address - Street 2:APT.16I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-9313
Practice Address - Country:US
Practice Address - Phone:212-580-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO14875-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP1968297OtherOXFORD
NY6218587OtherUNITED BEHAVIORAL
NYNG3632OtherEMPIRE BLUE CROSS-BLUE SH
NY5926329OtherAETNA
NY5926329OtherAETNA